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Meta-Analysis
. 2023 Jun;143(6):3055-3076.
doi: 10.1007/s00402-022-04508-z. Epub 2022 Jul 16.

Systematic review of the association between isolated musculoskeletal hypermobility and adolescent idiopathic scoliosis

Clare Shere  1 , Emma M Clark  2
Affiliations
Meta-Analysis

Systematic review of the association between isolated musculoskeletal hypermobility and adolescent idiopathic scoliosis

Clare Shere et al. Arch Orthop Trauma Surg. 2023 Jun.

Abstract

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.

Keywords: Adolescent idiopathic scoliosis; Musculoskeletal hypermobility; Systematic review.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
PRISMA diagram for selection of eligible studies
See this image and copyright information in PMC

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