Influence of growth hormone treatment on radiographic indices of the spine: Propensity-matched analysis

Yeo Hon Yun, Soon Sun Kwon, Youngdo Koh, Dong Jun Kim, Jonghyun Ahn, Seung Yeol Lee

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13 Scopus citations


Background: We performed this study to investigate the influence of recombinant human growth hormone (rhGH) therapy on radiographic indices of the spine using propensity-matched analysis. Methods: Patients with idiopathic short stature who had undergone both growth hormone therapy and whole-spine radiographs more than twice prior to 15years of age were included in the patient group. Other patients who had undergone whole-spine radiographs more than twice prior to the same age during regular checkups for idiopathic scoliosis formed the control group. Propensity-matched analysis was performed to reduce the selection bias. The scoliosis Cobb angle, coronal balance, apical vertebral translation, apical rotation, and pelvic obliquity were measured from the radiographs taken at the periodic follow-ups. The rate of progression of the measurements was adjusted by multiple factors using a linear mixed model with sex as the fixed effect and age and each subject as the random effects. Results: Using a propensity-matched analysis, 48 patients were finally included in both groups. The scoliosis Cobb angle increased by 1.0° (p<0.001) per year in the patient group, whereas there was no significant annual change in the control group (p=0.496). Female patients showed a greater scoliosis Cobb angle (1.8°, p=0.039) compared with male patients. There was no significant difference between the patient and control groups in coronal balance (p=0.264). Apical vertebral translation per year was increased by 1.2mm (p<0.001) in the patient group and 0.5mm in the control group (p=0.003). Conclusion: Radiographic examination revealed that growth hormone therapy for idiopathic short stature affected the progression of the scoliosis Cobb angle and apical vertebral translation on the coronal plane. Physicians should be aware that annual follow-up is required to evaluate the change in the curvature of the spine in patients undergoing rhGH treatment.

Original languageEnglish
Article number130
JournalJournal of Orthopaedic Surgery and Research
Issue number1
StatePublished - 6 Sep 2017

Bibliographical note

Funding Information:
This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science and ICT (NRF-2016R1C1B2008557). No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

Publisher Copyright:
© 2017 The Author(s).


  • Growth hormone
  • Propensity-matched analysis
  • Scoliosis


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