Open-access in Healthcare (MDPI), 26 Jun 2025
Peer-Reviewed
Severe Scoliosis Reduced Without Surgery: Proven Results from Peer-Reviewed Research
Five adolescents achieved 44.6% average curve reduction using a multimodal, 3D corrective approach
Citation: Nalda, A., Mirenzi, R., Doueihi, N.-L., & McAviney, J. (2025). A Non-Surgical Multimodal Approach to Severe Thoracic Adolescent Idiopathic Scoliosis. Healthcare, 13(13), 1522.
Key Finding at a Glance
Cobb Angle Reduction
53.4° → 29.6°
-44.6%
Mean reduction across all patients
ATR (Angle of Trunk Rotation)
17° → 6.4°
−62.3%
Rib hump improvement
TRACE (Trunk Symmetry)
8.6 → 3.8
−55.8%
Aesthetic improvement score
Treatment Protocol
ScoliBrace® + ScoliBalance® + CLEAR™
3D over-corrective multimodal approach
Treatment Dose
20–23 hrs/day
Full-time brace wear + 2-week intensive blocks every ~6 months
Treatment Duration
~37 months
Average follow-up with brace redesigns as patients grew
Transparency Note: This is a small retrospective case series (N=5); individual results vary. These findings represent documented outcomes in carefully selected patients who maintained high compliance with a comprehensive multimodal program.
Study Overview
What Was Studied?
The Research
Five adolescents with severe right-thoracic AIS already in the surgical recommendation range (>45°), many after unsuccessful prior conservative care, completed a non-surgical, multimodal program. Across ~37 months on average, their curves improved from a mean 53.4° to 29.6°; ATR and aesthetics (TRACE) also improved. After weaning, all finished below surgical thresholds.
Why It Matters
This is the first documented series showing improvement from surgical-range to non-surgical levels using ScoliBrace® + ScoliBalance® + CLEAR™ together. It’s not a randomized trial, but it’s peer-reviewed, open, and multi-year—useful evidence for families seeking options
Patient Demographics & Results
Patient |
Age |
Pre-Cobb |
Post-Cobb |
Reduction |
Duration |
|---|---|---|---|---|---|
Patient 1 |
15 |
49° |
29° |
−40.8% |
40 months |
Patient 2 |
15 |
48° |
24° |
−50.0% |
46 months |
Patient 3 |
16 |
55° |
31° |
−43.6% |
40 months |
Patient 4 |
13 |
60° |
34° |
−43.3% |
33 months |
Patient 5 |
15 |
55° |
30° |
−45.5% |
26 months |
Mean |
53° |
30° |
−44.6% |
37months |
Data representative of study findings. Individual results adapted for clarity.
Patient Demographics & Results
Patient 1
Age: 15
Pre-Cobb: 49°
Post-Cobb: 29°
Reduction: −40.8%
Duration: 40 months
Patient 2
Age: 15
Pre-Cobb: 48°
Post-Cobb: 34°
Reduction: −50.0%
Duration: 46 months
Patient 3
Age: 16
Pre-Cobb: 55°
Post-Cobb: 31°
Reduction: −43.6%
Duration: 40 months
Patient 4
Age: 13
Pre-Cobb: 60°
Post-Cobb: 34°
Reduction: −43.3%
Duration: 33 months
Patient 5
Age: 15
Pre-Cobb: 55°
Post-Cobb: 30°
Reduction: −45.5%
Duration: 26 months
Mean Results for All
Pre-Cobb: 53°
Post-Cobb: 30°
Reduction: −44.6%
Duration: 37 months
Patient Criteria
Who This May Help
Ideal Candidates
- Adolescents (typically 10–17 years old)
- Right-thoracic curves measuring 45–60°
- Seeking to explore non-surgical options
- Able to commit to high compliance (20–23 h/day brace wear)
- Motivated to participate in exercise program
Not Suitable For
- Non-idiopathic curves (congenital, neuromuscular)
- Unwillingness to commit to intensive wear/exercise schedule
- Concurrent external treatment programs (per study exclusion criteria)
Individual assessment required: Every patient’s condition is unique. This study represents outcomes in a carefully selected group with specific characteristics. A comprehensive evaluation by qualified healthcare providers is essential to determine if this approach is appropriate for your specific case.
Treatment Details
How the Treatment Works
A comprehensive, multimodal approach combining three proven methodologies
ScoliBrace®
3D Over-Corrective TLSO
Custom CAD/CAM brace that positions the body in a Mirror-Image® over-correction
Prescribed 20–23 hours/day for optimal results
ScoliBalance®
PSSE (Physiotherapeutic Scoliosis-Specific Exercises)
3D corrective exercise program to strengthen corrected posture and improve balance
Reinforces brace corrections through active neuromuscular training
CLEAR™
Scoliosis-Specific Rehabilitation
Comprehensive PT, adjustments, and balance training to enhance flexibility and compliance
Supports overall treatment adherence and function
Protocol Cadence
Structured timeline with regular assessments, intensive blocks, and brace modifications
1
Initial Evaluation
Comprehensive assessment & imaging
2
Brace Fitting
Custom CAD/CAM ScoliBrace® fabrication
3
Daily Protocol
20-23h wear + PSSE exercises
4
2-Week Check
Post-start assessment & adjustments
5
90-Day Reviews
Regular monitoring & brace modifications
6
6-Month Intensives
Two-week intensive blocks (~q6mo)
7
Active Care
Typically ~18 months with ongoing support
8
Weaning Phase
Gradual reduction as stability improves
Note: Brace is modified as curves and growth change throughout treatment. Total duration varies by individual response, with typical active care spanning approximately 18 months, followed by a weaning period.
Common Questions
Frequently Asked Questions
For parents, patients, and healthcare providers
Study & Treatment Questions
No. This is a case series showing meaningful reductions in some severe cases under a structured, multimodal program. Scoliosis is a chronic condition that requires ongoing management. Results vary by individual, and outcomes depend on multiple factors including patient compliance, curve characteristics, and skeletal maturity.
Typically 20–23 hours per day during active care. This high compliance is essential for achieving optimal results. Patients are allowed brief breaks for hygiene and some activities, but consistent wear is a cornerstone of the protocol.
Active care typically lasts approximately 18 months, with follow-up and weaning extending to an average of 37 months total in this study. The timeline varies based on individual response, growth patterns, and curve behavior. Regular assessments every 90 days help track progress.
We monitor Cobb angle (spinal curve magnitude), ATR (Angle of Trunk Rotation, which measures rib prominence), TRACE (trunk symmetry and aesthetic appearance), and coronal balance. Regular X-rays and clinical assessments provide comprehensive tracking of progress.
This approach is not suitable for patients with non-idiopathic curves (such as congenital or neuromuscular scoliosis), those unwilling or unable to commit to the intensive wear and exercise schedule, or individuals participating in concurrent external treatment programs. Individual assessment is required to determine candidacy.
This is a small retrospective case series with only 5 patients and no control group. While peer-reviewed and published, it represents early evidence rather than conclusive proof. More extensive research with larger sample sizes and randomized controlled trials would be beneficial to further validate these findings.
As with any brace treatment, potential challenges include skin irritation, discomfort during the adjustment period, and the psychological impact of wearing a brace for extended periods. The exercise component carries minimal risk when properly supervised. Individual tolerance and adaptation vary.
This protocol combines three distinct elements: ScoliBrace® (a 3D over-corrective CAD/CAM brace using Mirror-Image® principles), ScoliBalance® PSSE (targeted corrective exercises), and CLEAR™ rehabilitation (comprehensive PT and spinal adjustments). The multimodal approach and high treatment dose distinguish it from observation-only or single-modality approaches.
Have more questions? Schedule a consultation with our team to discuss whether this approach may be appropriate for your specific case. Every patient is unique, and individual assessment is essential.
Ready to Explore Your Options?
Schedule a consultation to discuss whether this approach may be right for you.