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Open Access Highly Accessed Research

Growth rates and the prevalence and progression of scoliosis in short-statured children on Australian growth hormone treatment programmes

Gregory A Day13*, Ian Bruce McPhee1, Jenny Batch2 and Francis H Tomlinson1

Author Affiliations

1 Department of Surgery, University of Queensland, Brisbane, Australia

2 Department of Paediatrics and Child Health, University of Queensland, Brisbane, Australia

3 Level 5, St Andrews Place, 33 North Street, Spring Hill, Queensland, Australia 4000

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Scoliosis 2007, 2:3  doi:10.1186/1748-7161-2-3

Published: 22 February 2007

Abstract

Study design and aim

This was a longitudinal chart review of a diverse group (cohort) of patients undergoing HGH (Human Growth Hormone) treatment. Clinical and radiological examinations were performed with the aim to identify the presence and progression of scoliosis.

Methods and cohort

185 patients were recruited and a database incorporating the age at commencement, dose and frequency of growth hormone treatment and growth charts was compiled from their Medical Records. The presence of any known syndrome and the clinical presence of scoliosis were included for analysis. Subsequently, skeletally immature patients identified with scoliosis were followed up over a period of a minimum four years and the radiologic type, progression and severity (Cobb angle) of scoliosis were recorded.

Results

Four (3.6%) of the 109 with idiopathic short stature or hormone deficiency had idiopathic scoliosis (within normal limits for a control population) and scoliosis progression was not prospectively observed. 13 (28.8%) of 45 with Turner syndrome had scoliosis radiologically similar to idiopathic scoliosis. 11 (48%) of 23 with varying syndromes, had scoliosis. In the entire cohort, the growth rates of those with and without scoliosis were not statistically different and HGH treatment was not ceased because of progression of scoliosis.

Conclusion

In this study, there was no evidence of HGH treatment being responsible for progression of scoliosis in a small number of non-syndromic patients (four). An incidental finding was that scoliosis, similar to the idiopathic type, appears to be more prevalent in Turner syndrome than previously believed.