Ultra-long-term follow-up of pediatric spinal deformity problems: 23 patients with a mean follow-up of 51 years

Abstract

Background: The aim of this study was to analyze the true outcomes of a unique cohort of patients with spinal deformities who were treated as children and followed for 40 or more years.

Methods: Altogether, 23 patients were reviewed who had been originally treated in our community, whose original charts and radiographs were still available, and who had undergone recent evaluation.

Results: The diagnoses were congenital deformity in eight, adolescent idiopathic scoliosis in four, poliomyelitis in three, infantile idiopathic scoliosis in two, spondylolisthesis in two, and one each of tuberculosis and dwarfism. Sixteen had undergone fusion surgery.

Conclusions: Early spine fusion for deformity produced far better results than delayed fusion. A solid fusion at the end of growth remained unchanged. Degenerative changes outside the fusion area were rare and seldom required further surgery. In summary, 23 patients with a mean follow-up of 51 years after treatment are presented. Early fusion was far superior to delayed or nonsurgical treatment.

Fig. 1

A Case 2, a girl with 30° juvenile idiopathic scoliosis. B at age 47, the patient had 142° scoliosis. She had undergone a short posterior fusion at age 11 when her curve had reached 112°. She was in cor pulmonale at this time and died soon afterward

Fig. 2

A Case 7, a 15 year-old boy with severe residual problems of poliomyelitis. His scoliosis was rapidly progressive. B This sitting radiograph was obtained just prior to surgery when the patient was 15 years of age. C Upright radiograph at age 17 (2 years after surgery). D Upright radiograph at age 58 (43 years after surgery)