{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:15:59Z","timestamp":1783016159320,"version":"3.54.6"},"reference-count":53,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2023YFC2507700"],"award-info":[{"award-number":["2023YFC2507700"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Generalized joint hypermobility (\n                      <jats:styled-content style=\"fixed-case\">GJH<\/jats:styled-content>\n                      ) is prototypical clinical feature of hypermobility spectrum disorders, and emerging studies have found a correlation between\n                      <jats:styled-content style=\"fixed-case\">GJH<\/jats:styled-content>\n                      and structural spinal changes. This study aims to investigate the preoperative radiographic characteristics and clinical outcomes of patients with GJH and adolescent idiopathic scoliosis (AIS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with AIS were prospectively recruited between July 2023 and August 2024 and divided into GJH (Beighton score\u2009\u2265\u20096) and non\u2010GJH (Beighton score\u2009&lt;\u20096) groups. The GJH group was matched 1:1 with controls based on age (\u00b11\u2009year), sex, main curve magnitude (\u00b15\u00b0), curve type of the Lenke classification, triradiate cartilage status, and Risser stage (\u00b11 grade). Baseline characteristics and surgical data were recorded. Preoperative and immediately postoperative radiographic parameters were measured. The Scoliosis Research Society\u201022 revised (SRS\u201022r) questionnaire was collected preoperatively and at least 1\u2009year postoperatively. Univariate analysis and multivariable linear regression analysis were used to identify factors associated with main curve flexibility, TK, and T1 tilt angle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 136 consecutive patients were included, with 29 patients (21.3%) classified into the GJH group. After mating, the GJH showed greater flexibility of the main curve (60.0%\u2009\u00b1\u200927.7% vs. 45.8%\u2009\u00b1\u200922.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020) and increased thoracic kyphosis (22.9\u00b0\u2009\u00b1\u200911.5\u00b0 vs. 16.7\u00b0\u2009\u00b1\u200911.7\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031) compared to the control group. Multivariable linear regression analyses revealed that the GJH was correlated with increased spinal flexibility (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u200914.09,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015) and larger thoracic kyphosis (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20096.11,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043). The GJH group demonstrated a relatively higher risk of surgical complications compared to the non\u2010GJH group (17.2% [5\/29] vs. 4.7% [5\/107],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.036). However, no significant differences were observed in patient\u2010reported outcome measures (PROMs) between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with AIS, GJH is associated with increased spinal flexibility and greater thoracic kyphosis and, importantly, a higher risk of surgical complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.70361","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:50:08Z","timestamp":1780620608000},"page":"1414-1425","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Generalized Joint Hypermobility in Adolescent Idiopathic Scoliosis: Greater Curve Flexibility, Larger Thoracic Kyphosis, but Higher Complication Risk"],"prefix":"10.1111","volume":"18","author":[{"given":"Di","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing China"},{"name":"Beijing Key Laboratory for Genetic Research of Skeletal Deformity  Beijing China"},{"name":"Beijing Key Laboratory of Big Data Innovation and Application for Skeletal Health Medical Care Chinese Academy of Medical Sciences  Beijing China"},{"name":"State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kexin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing China"},{"name":"Beijing Key Laboratory for Genetic Research of Skeletal Deformity  Beijing China"},{"name":"Beijing Key Laboratory of Big Data Innovation and Application for Skeletal Health Medical Care Chinese Academy of Medical Sciences  Beijing China"},{"name":"State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangjie","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing China"},{"name":"Beijing Key Laboratory for Genetic Research of Skeletal Deformity  Beijing China"},{"name":"Beijing Key Laboratory of Big Data Innovation and Application for Skeletal Health Medical Care Chinese Academy of Medical Sciences  Beijing China"},{"name":"State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3129-5190","authenticated-orcid":false,"given":"Terry Jianguo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing China"},{"name":"Beijing Key Laboratory for Genetic Research of Skeletal Deformity  Beijing China"},{"name":"Beijing Key Laboratory of Big Data Innovation and Application for Skeletal Health Medical Care Chinese Academy of Medical Sciences  Beijing China"},{"name":"State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical 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