Adolescent idiopathic scoliosis: case report with 63-year follow-up postsurgery

Retrospective case report.

To provide true outcome analysis by a 63-year follow-up.

A 16-year-old girl had a posterior spine fusion for adolescent idiopathic scoliosis in 1939 and has been followed ever since. Both original photographs and radiographs as well as current material are available.

A follow-up of this duration has not previously been reported.

She had a solid T9-L3 arthrodesis and had no problems until age 50 when degenerative changes at L3-L4 required extension of the fusion to L4. When seen in 2002 at age 79, she had problems with degenerative disc disease at L4-S1 with spinal stenosis symptoms.

The original fusion area remained solid and without symptoms for 63 years. Distal degenerative changes began 34 years after her original surgery and are still present at the 63-year follow-up. These degenerative changes at L4-L5 and L5-S1 are often thought to be secondary to the arthrodesis to L4, but because they are extremely common in persons of this age who do not have scoliosis or a fusion mass to L4, it is not possible to imply a cause and effect relationship. True outcome results cannot be ascertained at a 2-year or even 10-year follow-up.