Congenital thoracic scoliosis with unilateral unsegmented bar and concave fused ribs: rib osteotomy and posterior fusion at 1 year old, anterior and posterior fusion at 5 years old with a 36-year follow-up.

STUDY
DESIGN: Case report.
OBJECTIVE: To document the 36-year follow-up of a patient with a fusion at age 1 year for congenital scoliosis with a unilateral unsegmented bar, convex hemivertebrae, and fused concave ribs. SUMMARY AND BACKGROUND DATA: Although early spine fusion has been recommended as a life-saving measure for this problem, very little information exists as to the long-term effect of such treatment.
METHODS: Original chart, radiographs and photographs were compared to the situation 36 years after surgery. Pulmonary function tests and blood gasses were obtained at follow-up.
RESULTS: At age 37, the patient is free of any respiratory complaints, is an avid golfer, is married with 2 children, and the manager of a large factory. His pulmonary volumes are about half of normal, but his blood gasses are normal.
CONCLUSION: The early fusion prevented the customary severe progression of this condition and early death due to cor pulmonale. He is a fully functioning member of society. Will more modern treatments with lengthening of the hemithorax provide a better outcome? Only time will tell.