Systematic review of the association between isolated musculoskeletal hypermobility and adolescent idiopathic scoliosis
Open accessAbstract
Introduction: Adolescent idiopathic scoliosis (AIS) affects 1–3% of the population, but its pathogenesis remains unclear. The coexistence of musculoskeletal hypermobility and scoliosis in many inherited syndromes raises the possibility that isolated musculoskeletal hypermobility may contribute to AIS development or progression. Methods: We performed a systematic review of the evidence for a relationship between isolated musculoskeletal hypermobility and AIS. A meta-analysis was planned, but if not possible, a narrative evidence synthesis was planned. Results: Nineteen studies met eligibility criteria for inclusion. One study was excluded due to insufficient quality. Substantial heterogeneity in study design and methodology negated meta-analysis, so a narrative review was performed. Of the 18 studies included, seven suggested a positive association and eight found no association. Three reported the prevalence of musculoskeletal hypermobility in individuals with AIS. Overall, there was no convincing population-based evidence for an association between musculoskeletal hypermobility and AIS, with only two case–control studies by the same authors presenting compelling evidence for an association. Although populations at extremes of hypermobility had a high prevalence of spinal curvature, these studies were at high risk of confounding. Wide variation in methods of measuring musculoskeletal hypermobility and the challenge of assessing AIS in population-based studies hinder study comparison. Conclusions: There is a paucity of high-quality evidence examining the association between isolated musculoskeletal hypermobility and AIS. Large-scale prospective studies with adequate adjustment for potential confounding factors could clarify the relationship between musculoskeletal hypermobility and AIS to elucidate its role in the pathogenesis of AIS.
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A recent systematic review found no association between isolated musculoskeletal hypermobility and adolescent idiopathic scoliosis, and the "wide variation in methods of musculoskeletal hypermobility" made study comparisons difficult so it was somewhat inconclusive.
“A recent systematic review found no association, the “wide variation in methods of musculoskeletal hypermobility” made study comparisons difficult so it was somewhat inconclusive.”
From Pediatric joint hypermobility: a diagnostic framework and narrative review (2023) · cites this paper as [71]
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- Authors
- Shere, C., & Clark, E. M.
- Affiliations
- Southmead Hospital (GB)
- Corresponding author
- Shere, Clare
- Venue
- Archives of Orthopaedic and Trauma Surgery
- Published
- 2022-07-16
- Volume
- 143
- Issue
- 6
- Pages
- 3055-3076
- ISSN
- 0936-8051 (ISSN-L)
- 1434-3916
- PMC
- PMC10192177
- OpenAlex
- W4285587548
- Cited by
- 11
- References
- 47
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 2 · 2023: 1
- FWCI
- 0.48
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Archives of Orthopaedic and Trauma Surgery (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Explore Bristol Research (publishedVersion, cc-by)
- Funders
- Wellcome Trust (204813/Z/16/Z)
- Topics
- Health Sciences › Medicine › Surgery › Scoliosis diagnosis and treatment
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Connective tissue disorders research
- Health Sciences › Medicine › Surgery › Pectus Deformity Diagnosis and Treatment
- Keywords
- adolescent idiopathic scoliosis, joint hypermobility, scoliosis pathogenesis, spinal curvature, confounding
- MeSH terms
- Adolescent, Humans, Prospective Studies, Scoliosis, Case-Control Studies
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