Scoliosis is common in people with Prader-Willi syndrome (PWS), occurring in approximately 80% of individuals over the age of 10 (compared to 3% in the general population). Because scoliosis often develops or progresses during periods of growth, families and healthcare providers have sometimes wondered whether growth hormone (GH) therapy could make scoliosis worse.
What does the research show?
Early studies raised the question of whether the increased growth associated with GH treatment might contribute to scoliosis. However, a randomized controlled study of 91 children with PWS found that children receiving GH had similar rates of scoliosis onset and progression as children who did not receive GH. In fact, the children receiving GH had greater height and more truncal lean body mass. The researchers concluded that scoliosis should not be considered a reason to avoid GH treatment.
A later study provided even stronger long-term evidence. Researchers followed 103 children with PWS who received GH for eight years and compared them with 23 age-matched children who did not receive GH.
After eight years of treatment:
- There was no significant difference in how many children developed scoliosis.
- There was no significant difference in the severity of scoliosis between the groups.
- Children receiving GH had greater height and more trunk lean body mass.
- Among children without scoliosis, higher bone mineral density of the lumbar spine was associated with a smaller spinal curve.
Together, these findings are reassuring: GH treatment does not appear to cause scoliosis or make an existing curve worse.
Scoliosis is common in PWS, and it may develop during the same years that a child is receiving growth hormone. If a child develops scoliosis while receiving GH, the curve should be evaluated and monitored as recommended by their healthcare team. However, scoliosis alone is not a reason to stop or avoid growth hormone therapy.
Learn more about the importance of growth hormone therapy for PWS.
