{"title":"Risk factors for scoliosis progression in children with idiopathic short stature on growth hormone therapy.","authors":"Xinkai Zhang, Haiping Ouyang, Xueben Han, Hailun Yao, Yu Zhou, Xing Liu","doi":"10.1186/s13018-025-06224-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To analyze the clinical characteristics of scoliosis in children with idiopathic short stature after growth hormone treatment, and to explore the influence of growth hormone treatment on the progression of scoliosis and the risk factors for the progression of scoliosis.</p><p><strong>Methods: </strong>A retrospective study of children with scoliosis treated with growth hormone between January 2021 and June 2024 was conducted, analyzing the clinical characteristics of scoliosis and comparing the progression rate of scoliosis between the exposure group and the control group. Independent risk factors for exacerbation of scoliosis were determined by univariate and multifactorial logistic regression analysis.</p><p><strong>Results: </strong>In this study, the average Cobb angle at initial diagnosis of scoliosis during recombinant human growth hormone (rhGH) therapy was 11.86° across all children, with a maximum value not exceeding 20°, consistent with mild scoliosis. Comparative analysis revealed significantly greater Cobb angles in females versus males at both initial angle (11.40 ± 1.72° vs. 12.25 ± 2.64 °, p<0.01) and outcome angle (10.83 ± 1.85° vs. 11.77 ± 2.60°, p < 0.01) And apical vertebrae were distributed in thoracic 10- lumbar 1 (64.17%). The progression rate of scoliosis in the exposure group was significantly higher than that in the control group, and the risk ratio was 4.26. In the exposed group, the scoliosis progression rate was 17.02% (8/39) in males versus 20.00% (13/52) in females (p = 0.69). Within controls, progression rates were 4.35% (2/44) in males and 4.44% (2/43) in females (p = 1.00). Univariate and multivariate logistic regression analyses showed that continued growth hormone treatment and the initial Cobb Angle were independent risk factors for scoliosis progression.</p><p><strong>Conclusion: </strong>(1) Scoliosis developing in children with idiopathic short stature (ISS) receiving growth hormone (GH) therapy predominantly manifests as mild curvature. (2) If scoliosis develops during GH therapy, continued treatment may increase the risk of scoliosis progression. (3) Patients with smaller initial Cobb Angles are at higher risk of progression, necessitating closer clinical monitoring for this subgroup.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"859"},"PeriodicalIF":2.8000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482458/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Surgery and Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13018-025-06224-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To analyze the clinical characteristics of scoliosis in children with idiopathic short stature after growth hormone treatment, and to explore the influence of growth hormone treatment on the progression of scoliosis and the risk factors for the progression of scoliosis.
Methods: A retrospective study of children with scoliosis treated with growth hormone between January 2021 and June 2024 was conducted, analyzing the clinical characteristics of scoliosis and comparing the progression rate of scoliosis between the exposure group and the control group. Independent risk factors for exacerbation of scoliosis were determined by univariate and multifactorial logistic regression analysis.
Results: In this study, the average Cobb angle at initial diagnosis of scoliosis during recombinant human growth hormone (rhGH) therapy was 11.86° across all children, with a maximum value not exceeding 20°, consistent with mild scoliosis. Comparative analysis revealed significantly greater Cobb angles in females versus males at both initial angle (11.40 ± 1.72° vs. 12.25 ± 2.64 °, p<0.01) and outcome angle (10.83 ± 1.85° vs. 11.77 ± 2.60°, p < 0.01) And apical vertebrae were distributed in thoracic 10- lumbar 1 (64.17%). The progression rate of scoliosis in the exposure group was significantly higher than that in the control group, and the risk ratio was 4.26. In the exposed group, the scoliosis progression rate was 17.02% (8/39) in males versus 20.00% (13/52) in females (p = 0.69). Within controls, progression rates were 4.35% (2/44) in males and 4.44% (2/43) in females (p = 1.00). Univariate and multivariate logistic regression analyses showed that continued growth hormone treatment and the initial Cobb Angle were independent risk factors for scoliosis progression.
Conclusion: (1) Scoliosis developing in children with idiopathic short stature (ISS) receiving growth hormone (GH) therapy predominantly manifests as mild curvature. (2) If scoliosis develops during GH therapy, continued treatment may increase the risk of scoliosis progression. (3) Patients with smaller initial Cobb Angles are at higher risk of progression, necessitating closer clinical monitoring for this subgroup.
期刊介绍：
Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues.
Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications.
JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.
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