Radiographic Sagittal Alignmemnt and Kinetic Chain Alterations in Geriatric Patients with Scoliosis:
A Case Series
Research Focus: This peer-reviewed case series examines the application of CLEAR Institute non-surgical protocols to geriatric patients with a long-standing history of adolescent idiopathic scoliosis (AIS). The study evaluates radiographic outcomes, functional improvements, and kinetic chain restoration in older adults with chronic scoliosis-related pain and dysfunction.
Patient Population: Two geriatric female patients (ages 66 and 74) with documented AIS history spanning 50+ years presented with chronic pain, functional limitations, and forward head posture. Both had been told surgical intervention was their only treatment option.
Treatment Approach: Multimodal non-surgical rehabilitation using CLEAR Institute protocols including scoliosis-specific spinal adjustments, customized rehabilitative exercises, spinal traction and decompression, postural re-education, and neuromuscular re-training. Treatment duration: 12-16 weeks with comprehensive radiographic assessment.
Clinical Outcomes:
- Pain Reduction: Case 1 improved from 6/10 to 3/10 (50% reduction). Case 2 demonstrated similar clinically meaningful pain reduction.
- Functional Rating Index: Both patients showed 37-42% improvement in functional capacity and activities of daily living.
- Radiographic Findings: Measurable improvements in cervical lordosis, correction of forward head posture, and restoration of sagittal spinal alignment.
- Postural Improvement: Significant reduction in forward head posture and trunk asymmetry.
- Functional Capacity: Enhanced ability to walk, stand, and perform daily activities without assistive devices.
Key Research Hypothesis:
In geriatric patients with adolescent idiopathic scoliosis, chronic pain and functional dysfunction may originate from long-term kinetic chain dysfunction and accelerated compensatory degeneration rather than from the primary scoliotic curve itself. This finding suggests that comprehensive assessment of global spinal alignment and multimodal non-surgical rehabilitation can yield significant clinical improvement in this population, challenging the traditional assumption that older adults with scoliosis have limited treatment options.
Clinical Significance: This research demonstrates that evidence-based, non-surgical treatment protocols can deliver measurable clinical improvement in geriatric scoliosis patients. The findings support a paradigm shift in understanding how long-standing scoliotic deformity contributes to pain and dysfunction through kinetic chain compensation rather than through the curve alone. The study provides level 4 evidence (case series) supporting the efficacy of CLEAR Institute protocols in this understudied population.
Treatment Implications: Geriatric patients with a history of adolescent idiopathic scoliosis should not assume surgical intervention is their only option for pain relief. Comprehensive, non-surgical, multimodal rehabilitation targeting global spinal alignment and kinetic chain restoration can produce clinically meaningful improvement in pain, functional capacity, and quality of life. Early intervention and comprehensive assessment of compensatory patterns are recommended.
Research Context: This case series addresses a significant gap in the literature regarding treatment outcomes for geriatric scoliosis patients. Most published research focuses on adolescent idiopathic scoliosis or adult scoliosis in younger populations. This study provides evidence for the application of CLEAR Institute protocols to older adults with complex spinal histories, demonstrating that age alone should not preclude consideration of non-surgical rehabilitation approaches.
Full Citation:
Whelan JP, Dick JM. Radiographic Sagittal Alignment and Kinetic Chain Alterations in Geriatric Patients With Scoliosis: A Case Series. Cureus. 2026;18(3):e105827. doi:10.7759/cureus.105827
