Is there a link between scoliosis
and growth hormones?
BY NASIM DARIANI
Background Information on Growth Hormones
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Growth hormone is a protein-based peptide which
stimulates growth, cell reproduction, and
regeneration in humans and animals.
Growth hormone injections are used to treat
children’s growth disorders/growth hormone
deficiencies because their pituitary glands cannot
produce the proper amount of growth hormones
resulting in a short stature.
Basically, the hormone tells your bones and muscles
to grow.
GHD(growth hormone deficiency) can occur in
infancy or later in childhood. If detected early, the
child can a reach a normal height.
GHD may be treated through growth hormone
therapy, which your doctor must prescribe.
Treatment consists of a daily injection of growth
hormones until your doctor decides when to stop.
Side effects include of blurred vision, tingling
sensation in skin, numbness, dizziness, ear
infections, headaches, nausea, and vision changes.
Growth hormones also cause rapid growth which
can lead to other problems.
For example, the progression of scoliosis can occur
in children who experience rapid growth.
Growth Hormone Information Cont.
 Growth hormone therapy is
often times given a bad name
because of athletes who abuse
the treatment.
 Also, some are beginning to
use the treatment on healthy
short children. According to
Arthur Caplan, a bioethicist
from University of
Pennsylvania , “we’re
beginning to accept artificial
means to improve healthy
children”.
 Even though growth hormone
therapy is very controversial
for some it can prove to be
very helpful.
Growth Hormone Treatment Success Story
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For 14 year old Michael Finley, height
was important to him because he
wanted to make his school’s basketball
team.
Once tryouts came, Finley did not
make the team despite his efforts and
put the blame on his height.
Dr. Hardin, a pediatric
endocrinologist, put Michael on
growth hormones because he did not
keep up with the growth curve and he
had potential to grow based on his
family’s stature.
In the course of a year, Michael grew 3
to 4 inches.
His doctor even estimates that he will
grow to be 6 feet tall.
Overall, Michael and his family are
very happy with the results and are
glad they chose growth hormone
therapy.
Background Information on Scoliosis
 Scoliosis is a disorder resulting in
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an abnormal curvature of the
spine. People with scoliosis form
a “C” or “S” shape in their spine.
There is no cure for scoliosis and
cause is unknown, but scoliosis is
treatable.
Treatments consists of early
scoliosis screening, regular
check-ups, wearing a back brace,
and in extreme cases surgery
Scoliosis is more common in girls
than in boys and is hereditary.
Doctors monitor scoliosis more
cautiously during puberty
because the body experiences
rapid growth and the curve may
worsen in times of rapid growth.
Types of Treatment for Scoliosis
A child with scoliosis should
be monitored by his or her
doctor every 4 to 6 months to
check for any changes in the
curvature of their spine.
• If the child’s bones are still
growing, the doctor may
recommend a back brace.
• The back brace will prevent
the curve from progressing.
• Braces are worn day and
night and its effectiveness
increases with the number of
hours its worn.
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Scoliosis Treatment Cont.
 In severe cases of scoliosis, your
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doctor may suggest surgery to
prevent the curve from getting
worse.
Most common type of surgery is
spinal fusion.
Spinal fusion consists of
surgeons connecting two or more
bones in the spine together to
prevent movement.
Metal rods, hooks, and screws
hold that part of the spine
straight, while old and new bones
fuse together.
Spinal fusion surgery has a very
high success rate and rarely is a
second surgery needed.
Scoliosis Success Story (Amanda’s story)
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Amanda’s scoliosis was first detected
when she was 13 years old.
A year later her curve worsened and she
needed surgery.
Amanda feared that her days as an
athlete would be put to an end or
greatly limited. However, Amanda was
proved wrong.
According to her doctor, the operation
went very well and post surgery,
Amanda had minimal complaints.
Amanda had even gained 3 inches to
her height after the surgery.
Amanda had a fast recovery and
returned to school 5 weeks after her
surgery.
A few months later she was able to
return to cheering, dancing, and doing
gymnastics.
Cost of Treatments
 Growth Hormone
Therapy
• Growth hormones are
covered by insurance only if a
doctor has prescribed them.
• If not covered by insurance,
hGH costs $150 per bottle
and one may spend about
$8,000 to $10,000 a year on
medication and doctor visits.
 Scoliosis
 Scoliosis treatment is typically
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covered by insurance.
If your insurance does not
cover treatment it costs:
Monitoring the curve:
$3,386.25 (includes visits and
x-rays, no treatment)
Treatment with back brace:
$10, 836.00 (does not include
cost of brace)
Back Brace: can range from
$10,000 to $20,000
Surgery: $120,000
Is There a Link Between Scoliosis and Growth
Hormones?
 According to the Foundation
for Prader Willi Foundation
growth hormone therapy does
not worsen scoliosis.
 The incidence of scoliosis in
Prader Willi Syndrome is very
high. (80% in children over
age 10)
 When growth hormone
therapy became part of the
treatment for PWS, one
concern was the possibility of
increasing the degree of
curvature in the spine. (since
scoliosis progresses during
times of rapid growth)
 In fact, scoliosis is frequent in
children with PWS who are
receiving growth hormones.
Cont.
 However, this does not
mean that growth
hormones are the main
cause of scoliosis.
 Even the studies that were
conducted did not detect
any difference in the
severity of scoliosis
regardless of whether GH
therapy was used or not.
 In another article by
Gregory A Day, titled
Growth rates and the
prevalence and
progression of scoliosis in
short-statured children on
Australian growth
hormone treatment
programmes, the
conclusion was that there
was no evidence of HGH
treatment responsible for
the progression of scoliosis.
Cont.
 In this study, 185 patients
were recruited and their
dosage and frequency of
growth hormone treatment
were recorded.
 These patients were followed
up over a 4 year period and
the progression and severity
of their scoliosis was
recorded.
 The results showed that the
growth rate of those with and
without scoliosis were not
statistically different and
HGH treated was not ceased
because of progression of
scoliosis.
 In conclusion, in this study
there was no evidence to show
that HGH treatment is
responsible for the
progression of scoliosis.
On the Other Hand
 At the Children’s Hospital
of Philadelphia, 250
children being treated with
growth hormones were
screened for scoliosis.
 In 10 of 250 patients,
scoliosis developed.
 6 of of those 10 patients
had progressive curves and
required an orthosis.
 Even after a brace, 3 of
those patients needed
spinal fusion surgery.
 In conclusion, growth
hormones may increase the
risk of rapid progression of
scoliosis.
Final Answer
 There does not seem to be a definite answer as to
whether there is a link between scoliosis and growth
hormones.
 As you can see, some studies say there is not a link while
one does say there is a link.
 I have come to the conclusion that growth hormones are
not the main cause of scoliosis but they can have an
impact on scoliosis. According to Genotropin, in
children experiencing rapid growth, curvature of the
spine may develop or worsen. Patients with scoliosis
should be checked more cautiously to make sure their
scoliosis does not worsen during growth hormone
therapy.
Community Outreach
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For my community outreach aspect of the project, I
emailed 2 organizations and conducted a survey.
I heard back from the Scoliosis Research Society
however they were unable to provide me with an
answer as to if there is a link between scoliosis and
growth hormones.
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Overall, the 51 people who took my survey displayed
a strong understanding of scoliosis and growth
hormones. For example, only 2/50 (1 skipped) did
not know what scoliosis is. The general consensus
for the answer to this question was scoliosis is the
curvature of the spine. The next question more
answered incorrectly than correctly. The correct
answer was false, scoliosis only affects 2-3% of the
population. Similarly more answered the following
question incorrectly again. To my surprise as well,
there is no cure to scoliosis. Scoliosis can only be
treated not cured. For the last question concerning
scoliosis, only 5 were unsure of scoliosis treatment.
A majority said either a back brace or surgery and
some even said growth hormones. It is interesting
how some said growth hormones as a treatment for
scoliosis because according to an article in the New
York Times, one of the treatments listed is growth
hormone therapy. Moving on to the questions about
growth hormones, a majority answered both
questions correctly. Lastly, 30 answered yes to if
growth hormones increase the curvature of the spine
whereas 20 said it does not.
True or False?
 Spinal fusion surgery can cost $200,000.
 People with scoliosis form an “S” or “Z” shape in
their spine.
 Some side effects of growth hormone therapy
consists of blurred vision, nausea, and vision
changes.
 According to the Foundation for Prader Willi
Foundation growth hormone therapy does worsen
scoliosis.
Why I Chose This Question
 I chose this question because I can easily relate to it. I
was diagnosed with scoliosis when I was in fifth grade
however the curve was small enough so I did not need
any further treatment. However as I got older the curve
began to progress and during that time I was also
diagnosed with growth hormone deficiency, which meant
I needed daily growth hormone injections. During the
growth hormone treatment, the curve in my spine got
progressively worse which required for me to wear a back
brace for 20 hours a day. My parents decided to end the
growth hormone injections as my spine worsened
however it was too late and my back required surgery.
After this incident, it led to me question if there is a
correlation between growth hormones and scoliosis.
Work Cited
 “Growth Hormone Therapy Does Not Worsen Scoliosis." Foundation for
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Prader-Willi Research |. N.p., n.d. Web. 10 June 2013.
"Health Guide." Scoliosis Treatment. N.p., n.d. Web. 10 June 2013.
"Kids' Hormones: A Growth Industry." CBSNews. CBS Interactive, n.d.
Web. 10 June 2013.
Staff, Mayo Clinic. "Definition." Mayo Clinic. Mayo Foundation for
Medical Education and Research, 03 Feb. 2012. Web. 10 June 2013.
CANNING, ANDREA, and ALBERTO ORSO. "HGH -- Human Growth
Hormone -- Injections Give Couple New Energy, Enjoyment of Life.”
ABC News. ABC News Network, 09 Aug. 2011. Web. 10 June 2013.
"Growth Rates and the Prevalence and Progression of Scoliosis in Shortstatured Children on Australian Growth Hormone Treatment
Programmes." Scoliosis. N.p., n.d. Web. 10 June 2013.
"Result Filters." National Center for Biotechnology Information. U.S.
National Library of Medicine, n.d. Web. 10 June 2013.