The association of congenital diaphragmatic hernia with scoliosis.

Abstract

Purpose: To determine the prevalence of scoliosis in patients who have undergone surgical repair of CDH and attempt to assess the aetiology of scoliosis in affected cases.

Methods: A prospectively collected database of patients with CDH treated in a single centre between 1997 and 2023 was reviewed. Cases with adequate records who continued to reside locally having survived beyond age 2 and > 2 years following CDH repair were included. Congenital spinal abnormalities and scoliosis were diagnosed from imaging studies. In those who developed scoliosis, medical notes were reviewed to assess the aetiology of scoliosis and its treatment.

Results: 145 patients (92 male) who had undergone CDH repair were included. The median age at CDH repair was at 4 days. The mean time from CDH repair to this study was 14.1 years (2.0-26.2). 15 developed scoliosis (10.3%). In 8 cases, the scoliosis was considered a reflection of multisystem abnormalities including congenital vertebral anomalies in 3 cases (2%). In the 7 remaining cases the scoliosis had no obvious cause. Of those with scoliosis, to date, 3 have had surgical treatment with 1 awaiting surgery, 7 have not required scoliosis treatment and 4 have died.

Conclusions: Scoliosis is relatively common in those who have undergone CDH repair, typically presenting before age 10 years. Scoliosis when present was commonly part of a multisystem issue, with congenital vertebral anomalies rare. There appears no strong association between use of synthetic patch and scoliosis. Few children undergoing CDH repair will require treatment of a scoliosis.