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Lack of joint hypermobility increases the risk of surgery in adolescent idiopathic scoliosis

Haller, Gabea,*; Zabriskie, Hannaha,*; Spehar, Shelbya; Kuensting, Timothya; Bledsoe, Xaviera; Syed, Alia; Gurnett, Christina A.a,b,c; Dobbs, Matthew B.a

Journal of Pediatric Orthopaedics B: March 2018 - Volume 27 - Issue 2 - p 152–158
doi: 10.1097/BPB.0000000000000489

Generalized joint hypermobility (GJH) is a risk factor for developing adolescent idiopathic scoliosis (AIS); however, it is not known whether joint hypermobility influences the risk of progression to surgery. Beighton joint hypermobility scores were assessed in 570 female AIS patients. Multivariate analysis was carried out to determine whether Beighton hypermobility scores were predictors of surgical intervention. In this female AIS cohort, 24.7% (141/570) had GJH (Beighton score ≥4). Multivariate analysis showed that GJH did not influence the risk of surgery, although having no joint hypermobility (Beighton score=0) increased risk (odds ratio: 1.89; P=0.003). Females who had no hypermobility (score=0) had significantly larger curves than individuals who scored at least one point on the Beighton scale [50° (interquartile range: 26) vs. 42° (interquartile range: 24), P=0.001]. Evaluation of specific measures of joint hypermobility indicated that females who could not touch their palms to the floor were 2.1-fold more likely to have surgery than patients who could perform this task (P=0.001). None of the other features measured on the Beighton score correlated with surgical risk. The lack of joint hypermobility increases the odds of surgery in females with AIS. Specifically, inability to touch the palms to the floor is an indicator of progression to surgery.

Departments of aOrthopaedic Surgery


cPediatrics, Washington University, St Louis, Missouri, USA

*Gabe Haller and Hannah Zabriskie contributed equally to the writing of this article.

Correspondence to Matthew B. Dobbs, MD, One Children’s Place, Suite 4S60, Washington University School of Medicine, St Louis 63110, Missouri, USA Tel: +1 314 454 4814; fax: +1 314 454 4817; e-mail:

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