title: Growth hormone supplement treatment reduces the surgical risk for Prader-Willi Syndrome patients.
abstract: BACKGROUND
  Many complications have been reported to occur with surgery for scoliosis in Prader-Willi Syndrome (PWS). However, growth hormone (GH) treatment has contributed to improvements in height, body composition, bone density and breathing functions in PWS patients. The purpose of this study was to investigate patients who underwent surgery for scoliosis in PWS.
  
  
  METHODS
  There were 136 PWS patients being followed-up by the Pediatrics Department of our hospital. Among these, we investigated nine patients who had undergone surgery. Their mean age was 11 years. The mean follow-up period was 6 years 10 months.
  
  
  RESULTS
  The mean body mass index was 22.5 kg/m(2). GH therapy was administered to eight patients. Brace treatment was performed in two patients. Spinal correction and fusion were performed in six patients, and the growing rod method was performed in three patients. Necessary reoperations were performed in two patients. For the total 11 surgeries in the nine patients, the mean blood loss was 397 ml and the mean operation time was 4 h and 20 min. The mean Cobb angles were 76.0 degrees preoperatively and 35.8 degrees at follow-up. Regarding complications, one patient experienced early dislodgment of the hook and one patient experienced a superior wound infection.
  
  
  CONCLUSIONS
  There were no severe complications such as deep infections or neurovascular damage. A few obese patients underwent surgery, but there were no dangerous complications. Overall, we consider that GH treatment before surgery may reduce postoperative complications. The growing rod method was effective for PWS patients who resisted brace treatment owing to mental retardation.
authors.affiliation: Department of Orthopedic Surgery, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minami-Koshigaya, Koshigaya, Saitama, 343-8555, Japan. nakayuta@dokkyomed.ac.jp
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Toshiro
authors.initials: T
authors.lastname: Nagai
authors.forename: Takahiro
authors.initials: T
authors.lastname: Iida
authors.forename: Satoru
authors.initials: S
authors.lastname: Ozeki
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nohara
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011218:Prader-Willi Syndrome / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D012086:Reoperation; D012306:Risk; D012600:Scoliosis / Q000150:complications / Q000601:surgery*
chemical_list: D019382:Human Growth Hormone