# Factors contributing to severe scoliosis after open chest surgery for congenital heart disease: a case–control analysis

## TL;DR

This study identifies factors like younger age at first surgery and multiple chest operations that increase the risk of severe scoliosis in congenital heart disease patients.

## Contribution

The study isolates scoliosis risk factors in CHD patients without syndromes, clarifying the role of surgical and demographic variables.

## Key findings

- Patients with severe scoliosis were more likely to be female and have younger ages at first surgery.
- Multiple open chest surgeries and severe CHD with cardiomegaly were linked to severe scoliosis progression.
- Spinal deformity monitoring is crucial for CHD patients undergoing multiple surgeries.

## Abstract

Previous reports have identified factors associated with open chest surgery for congenital heart disease (CHD) and scoliosis. However, these reports included conditions such as Down syndrome and Marfan syndrome, which involve both cardiac disease and scoliosis. The relationships between these factors and open chest surgery remain unclear. This study aimed to identify factors contributing to severe scoliosis in CHD patients who have undergone open chest surgery.

Seventy-four post-CHD surgery patients with severe scoliosis (Scoliosis group) and 30 post-CHD surgery patients without scoliosis (NS group), excluding those with any syndrome or intellectual disability, were retrospectively analyzed. Patient background characteristics and radiographic parameters were compared between the NS and Scoliosis groups. Furthermore, the patients in the Scoliosis group were classified into three categories, namely, mild scoliosis, moderate scoliosis, and severe scoliosis, and the results were compared among the four groups.

Eighteen patients in the NS group and 63 in the Scoliosis group met the inclusion criteria. Compared with the NS group, the Scoliosis group included significantly more girls and patients who had younger ages at first CHD surgery and multiple open chest surgeries. Severe scoliosis progression was observed in patients who underwent multiple surgeries for severe CHD with cardiomegaly.

Progression to severe scoliosis was noted in patients with younger ages at first CHD surgery and those who underwent multiple surgeries for severe CHD. Assessing spinal deformities should be a key aspect of postoperative care for CHD, particularly in patients with severe CHD who are undergoing multiple chest surgeries.

III.