JAAOS - 2026-09-11 - Journal Article
The Association of Long-Term Cardiac Issues for Adult Patients With Versus Without Scoliosis.
Dhodapkar MM, Jeong S, Halperin SJ, Patel T, Grauer JN, Tuason D
Topics
Key Takeaway
Adults with idiopathic scoliosis carry 11–72% increased odds of cardiac comorbidities (OR 1.11–1.72), while neuromuscular scoliosis patients carry 17–330% increased odds (OR 1.17–4.30) across all measured cardiac endpoints.
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Summary
This study used the PearlDiver Mariner 157 database (2015–2021) to compare cardiac comorbidity rates in adults 18–65 with idiopathic, neuromuscular, and congenital scoliosis against age- and sex-matched controls. Multivariable logistic regression showed idiopathic scoliosis associated with increased odds of all cardiac endpoints (OR 1.11–1.72), neuromuscular scoliosis with the highest burden (OR 1.17–4.30), and congenital scoliosis with increased odds of all endpoints except ischemic cardiac disease (OR 1.27–2.14). Findings suggest scoliosis type-specific cardiac risk stratification is warranted in adult patients.
Key Limitation
Database methodology precludes controlling for curve magnitude, surgical correction history, or underlying syndromic diagnoses, making it impossible to determine whether the cardiac risk is attributable to scoliosis itself or shared comorbid conditions.
Original Abstract
INTRODUCTION
Scoliosis may be associated with long-term cardiac issues through developmental association or structural causes. There are limited data examining the correlation of different forms of scoliosis with cardiac issue beyond its association with congenital heart disease.
METHODS
Data were abstracted from the 2015-2021 October Mariner 157 with Control PearlDiver Data set. Patients older than 18 and younger than 65 years with idiopathic, neuromuscular, and congenital scoliosis were identified using International Classification of Diseases (ICD)-10 codes and separately matched 1:10 by age and sex to a random sample of individuals without a history of scoliosis who presented for office visits identified using CPT codes. The incidences of cardiac arrest, congestive heart failure (CHF), cardiac arrhythmia, valvular disease, atrial fibrillation/flutter, ischemic cardiac disease, and aggregated cardiac history were identified using ICD codes. These were compared between the matched scoliosis and control groups using univariable analysis and multivariable logistic regression.
RESULTS
Overall, 182,777 patients with idiopathic scoliosis, 16,845 with neuromuscular scoliosis, and 2,404 with congenital scoliosis were identified. Control patients were identified and matched 10:1 by age and sex to patients with each subtype of scoliosis. For idiopathic and neuromuscular scoliosis, multivariable logistic regression demonstrated increased odds of aggregate cardiac history and all individual cardiac comorbidities (odds ratio (OR) 1.11-1.72 for idiopathic scoliosis and OR 1.17-4.30 for neuromuscular scoliosis, P < 0.05 for all). For congenital scoliosis, there were increased odds of aggregate cardiac history and all individual cardiac comorbidities except for ischemic cardiac disease (OR 1.27-2.14, P < 0.05 for all except ischemic cardiac disease).
DISCUSSION
Patients with different types of scoliosis seem to be at greater odds of various electrical, structural, ischemic, and functional cardiac issues in adulthood.
CONCLUSION
Patients with different types of scoliosis are at greater odds of various cardiac issues in adulthood, which may help guide patient counseling and inform follow-up.