Article ID: 2026-0245
Background: Adolescent Idiopathic Scoliosis (AIS) is a multifactorial spinal deformity with unclear pathophysiology. Generalized Joint Hypermobility (GJH), characterized by increased joint range of motion due to ligamentous laxity, has been proposed as a potential contributing factor. However, its role in scoliosis susceptibility, severity, and treatment outcomes remains uncertain.
Methods: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and registered in PROSPERO. PubMed, Embase, and ProQuest were searched from inception to March 2026 for observational studies evaluating the association between GJH and AIS. Eligible studies included case–control, cohort, and cross-sectional designs. Outcomes were categorized into scoliosis susceptibility, curve severity, clinical outcomes, and biomechanical parameters. Due to heterogeneity in study design and outcome reporting, a qualitative synthesis was performed.
Results: Eight studies comprising 1,239 participants were included. Four studies evaluated scoliosis susceptibility; most reported a higher prevalence of hypermobility among individuals with scoliosis, and one study found increased odds of scoliosis in hypermobile individuals. Five studies assessed curve severity, and no consistent association was observed between hypermobility and Cobb angle or other radiographic parameters. Three studies evaluated clinical outcomes, with individuals with hypermobility generally showing greater correction following bracing or surgery. One study assessed biomechanical outcomes and reported reduced lumbar trunk rotation among individuals with hypermobility.
Conclusions: GJH may be associated with susceptibility to AIS, although the evidence is inconsistent and likely influenced by confounding. No consistent relationship was observed with curve severity, while limited data suggest that hypermobility may affect treatment responsiveness through differences in spinal flexibility rather than disease severity.
