Short stature and the effect of human growth hormone: Guidelines for the care of people with spina bifida.
Joseph O'Neil, John S Fuqua
PMID 32986629WHAT IT FOUND
Guidelines for spina bifida recommend tracking growth and pubertal changes, using arm span if height cannot be measured, and referring to endocrinology if growth concerns arise.
They do not recommend routine growth hormone without documented deficiency.
Key findings
01Guidelines recommend regular measurement and documentation of growth, including height or length, weight, and pubertal changes, to identify abnormal linear growth and enable timely referral.
02Physical therapy referral is recommended to maximize range of motion, strength, and functional mobility as appropriate for developmental age.
03Routine growth hormone use is not recommended for people with spina bifida when growth hormone deficiency is absent.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The paper is a guideline development document, not a trial of growth hormone in people with spina bifida. Many recommendations are based on clinical consensus because medical evidence was absent or not robust. Most growth hormone evidence in spina bifida is retrospective, small, short-term, and drawn from databases prone to bias and unclear measurement accuracy. There are no good data in spina bifida on fracture risk, bone density, muscle mass and strength, cardiometabolic outcomes, quality of life, or long-term adult height after treatment. Growth hormone testing is problematic because of limited specificity and a high false positive rate, so universal biochemical testing is not advised.
Declared interests
No author conflict-of-interest or funding declaration is provided in the supplied text; the publication types list U.S. government Public Health Service research support.
The easy way to misread this
Do not read this guideline as support for routine growth hormone treatment for short stature in spina bifida. The paper does not recommend growth hormone without documented deficiency, and most evidence is short-term height velocity in children with deficiency, not long-term function or outcomes.