Clinical Efficacy of an Innovative Multidimensional Traction Therapy in Moderate Adolescent Idiopathic Scoliosis

This protocol aims to determine whether a patient-specific, multidimensional traction (MDT regimen), delivered alongside standard bracing and mirror-corrective exercises, can improve structural correction in moderate adolescent idiopathic scoliosis (AIS). The study is a pilot randomized clinical trial (RCT) enrolling skeletally immature adolescents (Cobb 20 - 45°) and allocating them 1:1 to (i) brace plus mirror-corrective exercises or (ii) the same program augmented by MDT. Traction vectors are individualized to the curve pattern and flexibility. Interventions are provided over a 3-month period. The MDT arm receives supervised sessions 2x a week, and all participants complete standardized daily exercises and wear braces according to guideline-based prescriptions. The primary outcome is the change in the major-curve Cobb angle from baseline to post-treatment, measured on standardized standing radiographs using consistent end vertebrae and blinded dual reading. Safety, adherence, and adverse events are monitored throughout. In results, adding MDT to bracing and exercises yielded a greater reduction in the major-curve Cobb angle. This protocol operationalizes a reproducible, clinic-ready workflow for parameterized multi-vector traction as an adjunct to conventional nonoperative care, offering a framework to maximize immediate in-brace correction and promote follow-up curve regression. This trial provides methodology and preliminary evidence to support larger, longer follow-up studies through skeletal maturity.