Scoping Review of the Correlation between Infantile Chest Wall Surgery and Scoliosis Risk

Background The relationship between infantile chest wall surgeries and the risk of scoliosis onset has been poorly understood and controversial. Professional opinions on this subject have ranged from ascribing the surgeries performed as a cause of the scoliosis that responds to treatment differently from known scoliosis subtypes to no relationship exists between these conditions. Definition of Terms Chest wall surgery: for the purpose of this study, chest wall surgery refers specifically to thoracotomies and sternotomies. Scoliosis: 3-dimensional spinal deformation that exceeds 10 degrees of Cobb angle. The most frequently described clinical subtypes are: idiopathic, neuromuscular, degenerative, congenital, non-structural, and syndromic. Infantile: the surgeries targeted for study were performed between birth and 1 year of age. Theoretical Orientation This inquiry was conducted from the Biopsychosocial Theory orientation. Methods Our investigation began with an attempt at a meta-analysis by Ginzburg, White & Taylor, 2022 of the existing body of knowledge. A review of PubMed digital library was conducted using the search terms “scoliosis,” “thoracotomy,” “sternotomy,” “congenital heart disease,” and “CDH.” The identified publications were reviewed, in their entirety, for confounding variables such as co-occurrence of neuromuscular disorders. 13 studies were identified for inclusion, spanning publication dates 1993-2020. The data revealed was too heterogeneous to meta-analyze with different surgical, rehabilitation techniques and scoliosis detection strategies employed. A statistically significant majority of the studies included reported a positive correlation between the surgeries performed and the scoliosis risk. Numerous authors/researchers attributed post- surgical adhesions as the causal pathomechanism of the scoliosis seen.