Scoliosis after cardiac surgery for congenital heart disease: a long-term follow-up study.

Background: As survival among patients with congenital heart disease (CHD) has improved, scoliosis after cardiac surgery has increasingly been recognized. However, the clinical characteristics and risk factors associated with scoliosis severity remain incompletely understood. Methods: We retrospectively reviewed patients who underwent cardiac surgery for CHD at our center between 2000 and 2022 and conducted long-term follow-up. Patients who developed scoliosis were matched with controls without scoliosis using propensity score matching (PSM). Clinical and radiographic data were analyzed. Logistic regression was used to identify independent risk factors for greater scoliosis severity, and Kaplan-Meier analysis to evaluate cumulative incidence. Associations between cardiac morphology and scoliosis severity were also assessed. Results: A total of 39 patients who developed scoliosis after CHD surgery and 39 matched patients without scoliosis were included. The median follow-up duration for the overall cohort was 12.75 (10.55-18.15) years. Compared with the non-scoliosis group, patients with scoliosis had a significantly higher cardiothoracic ratio (CTR) [55.48 [51.68-58.81] vs. 52.04 [46.62-55.56], Conclusions: Scoliosis after cardiac surgery for CHD most commonly presented as a right-convex single thoracic curve. A higher CTR was associated with both the presence of scoliosis and greater scoliosis severity. Long-term spinal surveillance should be considered, particularly in high-risk children.