ABSTRACT
Scoliosis is characterized by one or several segments of the spine bending sideways, accompanied by vertebral rotation and sagittal imbalance with complex etiology. Scoliosis can be caused by congenital vertebral abnormalities, asymmetry of the paraspinal muscles due to neurological lesions, and malnutrition or metabolic disorders of bone tissue. Growth hormone is a peptide hormone that plays a key role in promoting human growth and development, especially in bone growth. When the secretion of growth hormone in children or adolescents in the rapid growth stage is insufficient, it may lead to the occurrence of idiopathic short stature (ISS) and growth hormone deficiency (GHD). In clinic, ISS and GHD are mainly treated by recombinant human growth hormone (rhGH). According to some early clinical reports, in the process of rhGH treatment, many patients occur scoliosis or the original scoliosis progression is aggravated. Therefore, many scholars conclude that rhGH treatment of ISS or GHD will lead to the occurrence or development of scoliosis. However, with the increase of clinical statistics and the further progress of research, many scholars found that rhGH treatment of ISS or GHD will only increase the Cobb angle of patients with scoliosis, but will not lead to the occurrence of scoliosis, that is, rhGH treatment of ISS or GHD will not increase the prevalence of scoliosis. At present, whether rhGH treatment of ISS and GHD can lead to scoliosis and aggravation of scoliosis remains controversial. Therefore, this paper summarizes and analyzes the correlation research on the risk of scoliosis complications in children treated with rhGH, and concludes that age, gender, body mass index, and growth potential are risk factors for the development or progression of scoliosis during treatment, and discusses the balance of advantages and disadvantages of using rhGH for ISS or GHD to provide a direction for future clinical guidance.
ABSTRACT
The morbidity of scoliosis in adolescents in China is about 3%-5%, 80%-85% of the patients are adolescent idiopathic scoliosis (AIS), whose etiology is unknown. Scoliosis is a structural spine disease occurring during puberty or before skeletal maturation. Scoliosis has a greatly negative impacton not only the growth and development of adolescent spine, but also the mental health of adolescents. Ocular disease is a common clinical disease in which the eye ball and its accessory structures have structural abnormalitiesordys function. Ocular disease snotonly bring in convenience to patients's life, but also may induce diseases in other organs. Recent studies have shown that various ocular diseases may have a potential impact on scoliosis, and quite a fewof patients with certain ocular diseases have higher incidence rate of scoliosis. Therefore, in this article, the etiological relationship between eye diseases and scoliosis will be summarized, which provides guidance and direction for the etiological research of scoliosis and eye diseases. After sorting out, we found that the relationship between ophthalmic diseases and scoliosis mainly concentrated in the following four aspects: choroidal thickness and scoliosis, Goldenhar syndrome, gene level and strabismus. Among them, the genetic relationship is the most complex, about 40 kinds of gene or chromosome abnormalities have been found to cause ocular diseases and scoliosis; Goldenhar syndrome, also known as oculo-auriculo-vertebral spectrum, first revealed the relationship between ocular diseases and scoliosis, but the current statistical relationship is still very vague. There are few studies on choroidal thickness and strabismus at home and abroad, which are statistical studies, only revealing the relationship between choroidal thickness and scoliosis, and there are many defects in the study of choroidal thickness, which need further research.