Control of juvenile idiopathic scoliosis during pubertal growth spurt through conservative treatment: a retrospective observational study

Whether prepubertal estrogen production impacts on the timing of puberty is not clear. We aimed to investigate prepubertal 24-h estrogen excretion levels and their association with early and late pubertal markers. Daily urinary excretion rates of estrogens of 132 healthy children, who provided 24-h urine samples 1 and 2 yr before the start of the pubertal growth spurt [age at takeoff (ATO)], were quantified by stable isotope dilution/GC-MS. E-sum3 (estrone + estradiol + estriol) was used as a marker for potentially bioactive estrogen metabolites and E-sum5 (E-sum3 + 16-epiestriol + 16-ketoestradiol) for total estrogen production. Pubertal outcomes were ATO, age at peak height velocity (APHV), duration of pubertal growth acceleration (APHV-ATO), age at Tanner stage 2 for pubic hair (PH2), genital (G2, boys) and breast (B2, girls) development, and age at menarche. Prepubertal urinary estrogen excretions (E-sum3 and E-sum5) were not associated with ATO, APHV, and age at PH2 but with duration of pubertal growth acceleration ( P < 0.01) in both sexes. Girls with higher E-sum3 reached B2 0.9 yr ( P = 0.04) and menarche 0.3 yr earlier ( P = 0.04) than girls with lower E-sum3. E-sum3 was not associated with age at G2 in boys ( P = 0.6). For most pubertal variables, the associations with E-sum3 were stronger than with E-sum5. In conclusion, prepubertal estrogens may not be critical for the onset of the pubertal growth spurt but are correlated with its duration in both boys and girls. Prepubertal estrogen levels may already predict the timing of girls' menstruation and breast development but do not appear to affect sexual maturation in boys.

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Are there gender differences in sagittal spinal pelvic inclination before and after the adolescent pubertal growth spurt?

European Spine Journal ◽

10.1007/s00586-014-3563-9 ◽

2014 ◽

Vol 24 (6) ◽

pp. 1168-1174 ◽

Cited By ~ 8

Author(s):

Weijun Wang ◽

Zhiwei Wang ◽

Zhen Liu ◽

Zezhang Zhu ◽

Feng Zhu ◽

...

Keyword(s):

Gender Differences ◽

Growth Spurt ◽

Pubertal Growth Spurt ◽

Pubertal Growth ◽

Pelvic Inclination ◽

Before And After

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Tracking of appendicular bone mineral density for 6 years including the pubertal growth spurt: Japanese Population-based Osteoporosis Kids Cohort Study

Journal of Bone and Mineral Metabolism ◽

10.1007/s00774-010-0213-0 ◽

2010 ◽

Vol 29 (2) ◽

pp. 208-216 ◽

Cited By ~ 12

Author(s):

Yuki Fujita ◽

Masayuki Iki ◽

Yukihiro Ikeda ◽

Akemi Morita ◽

Tomoharu Matsukura ◽

...

Keyword(s):

Bone Mineral Density ◽

Cohort Study ◽

Bone Mineral ◽

Japanese Population ◽

Population Based ◽

Growth Spurt ◽

Pubertal Growth Spurt ◽

Mineral Density ◽

Pubertal Growth

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Questions on the Use of Vitamin D3

PEDIATRICS ◽

10.1542/peds.66.3.483 ◽

1980 ◽

Vol 66 (3) ◽

pp. 483-484

Author(s):

Sonia Balsan ◽

Robert Steendijk

Keyword(s):

Growth Velocity ◽

Point Of View ◽

Hypophosphatemic Rickets ◽

Growth Spurt ◽

Vitamin D2 ◽

Pubertal Growth Spurt ◽

Dihydroxyvitamin D3 ◽

Pubertal Growth ◽

Careful Scrutiny ◽

Late Maturer

From their observations in a boy with hypophosphatemic rickets Chan and Bartter1 conclude that administration of 1α,25-dihydroxyvitamin D3 (1,25-(OH)2D3) is the treatment of choice for this disease. Since this point of view is not shared by everybody, it demands careful scrutiny. The conclusion rests on the increased growth velocity, the radiologic healing of the rachitic lesions, and the increase in serum phosphorus which occurred when treatment was changed from vitamin D2 to 1,25-(OH)2D3. From the growth curve of this boy it appears that the increase in growth velocity could represent the pubertal growth spurt in a late maturer.

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Conservative treatment of a scoliosis patient after two heart surgeries in early childhood – A case report

South African Journal of Physiotherapy ◽

10.4102/sajp.v77i2.1588 ◽

2021 ◽

Vol 77 (2) ◽

Author(s):

Hans-Rudolf Weiss ◽

Manuel Lay ◽

Tamisha Best-Gittens ◽

Marc Moramarco ◽

Mario Jimeranez

Keyword(s):

Case Report ◽

Conservative Treatment ◽

Best Practice ◽

Tanner Stage ◽

Growth Spurt ◽

Brace Treatment ◽

Pubertal Growth Spurt ◽

Patient Presentation ◽

Main Curve

Introduction: This is a case report of a juvenile female patient with scoliosis following two heart surgeries for congenital heart disease (CHD).Patient presentation, management and outcome: Initially, the premenarchial female was 9 years old and had a Tanner stage 2–3 with a single thoracic curve of 65° Cobb. Because of the high risk for progression, immediate brace treatment was proposed as the father declined surgery. The patient received intensive treatment according to the Schroth Best Practice® programme and a Gensingen Brace® designed for large thoracic curves. Over the 18 months following the initial visit, she received two additional braces. As a result, the progression of the main curve was prevented. The patient continues to maintain an improved cosmetic result and is currently at a Risser 2.Conclusion: Surgery performed for CHD in rare cases may lead to stiff spinal deformity as a consequence of that surgery. Progression of a severe and stiff curve was prevented during the most vulnerable phase of the pubertal growth spurt with an improved clinical result. Therefore, we assume that the patient may have a normal life in adulthood with minor restrictions only. Supported by pattern-specific high correction exercises and braces, these typical single thoracic curves can be re-compensated to a more balanced appearance, less prone to progression in adulthood.Clinical implications: Because of the relative high risks of spinal fusion and the long-term unknowns of such an intervention, high-impact conservative treatment should be implemented first before surgical correction is considered.

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Variability of the dynamics of somatometric parameters in schoolchildren with different nutritional status (longitudinal study)

Voprosy praktičeskoj pediatrii ◽

10.20953/1817-7646-2020-5-68-72 ◽

2020 ◽

Vol 15 (5) ◽

pp. 68-72

Author(s):

V.L. Gritsinskaya ◽

◽

V.P. Novikova ◽

A.I. Khavkin ◽

◽

...

Keyword(s):

Nutritional Status ◽

High Amplitude ◽

Physical Development ◽

Growth Spurt ◽

Pubertal Growth Spurt ◽

Pubertal Growth ◽

Normal Limits ◽

Study Participants ◽

Two Peaks ◽

Low Amplitude

Objective. To identify specific features of pubertal growth spurt in adolescents depending on their nutritional status in prepuberty. Patients and methods. We analyzed the dynamics of height and weight in 645 children (331 boys and 314 girls) aged between 8 and 16 years. All study participants were divided into three groups depending on whether their weight and height at the age of 8 years were within the normal limits given in the ‘WHO Growth Reference 2007’: children with physical development; underweight children; and overweight children. Results. The dynamics of somatometric parameters during pubertal growth spurt varied between children with different nutritional status. Underweight boys demonstrated prolonged and low-amplitude pubertal growth pattern; in boys with normal physical development, the growth spurt was usually shorter and had high amplitude. In overweight boys, the pubertal growth spurt started with higher annual increase in height, had a more pronounced amplitude, and was shorter than in peers (р < 0.001 ÷ р < 0.05). Both underweight girls and girls with normal physical development demonstrated low-amplitude pubertal growth spurt lasting for two years. Overweight girls had two peaks of pubertal growth spurt, which usually started earlier than in other girls (р < 0.001 ÷ р < 0.01). Conclusion. Our findings can be used as a guide for predicting pubertal spurt in children during medical examinations, determining adequate physical activity in physical education classes at school and in sports sections. Key words: children, nutritional status, pubertal growth spurt

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Precocious Puberty: Diagnosis, Evaluation, and Management

Pediatrics in Review ◽

10.1542/pir.14.9.336 ◽

1993 ◽

Vol 14 (9) ◽

pp. 336-367

Keyword(s):

The United States ◽

Gonadotropin Releasing Hormone ◽

Growth Spurt ◽

Transitional Stage ◽

Pubertal Growth Spurt ◽

Adrenal Androgen ◽

Secondary Sexual Characteristics ◽

Pubertal Growth ◽

Sexual Characteristics ◽

Physical Changes

Puberty is a transitional stage associated with many changes, both physical and emotional. The endocrinologic changes, consisting of two processes, gonadarche and adrenarche, result in the development of secondary sexual characteristics and the pubertal growth spurt. Gonadarche, the maturation of the gonads, is initiated by the episodic pulsatile secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus. Adrenarche refers to the increase in adrenal androgen secretion (the mechanism responsible for this is unknown). Both of these processes cause an increase in sex steroid secretion, which results in the physical changes of puberty. In the United States, normal puberty occurs between 8 to 13 years in girls and 9 to 14 years in boys.

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