However, we do not think that the occurrence of this scoliosis was completely caused by rhGH treatment, because both patients carry hotspot mutation of COL2A1 leading to SEDC, and the incidence of this disease is relatively high, which has been reported as 48% of 93 patients with molecularly confirmed SEDC or a related disorder in the previous literature (33). This evidence concerns the gene COL2A1 and scoliosis.