Radiographic Sagittal Alignment and Kinetic Chain Alterations in Geriatric Patients With Scoliosis: A Case Series

Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that originates in adolescence but carries lifelong biomechanical consequences. In geriatric patients, chronic pain associated with a history of AIS is frequently attributed to the scoliotic curve itself. This case series proposes an alternative framework. Pain in this population may originate from long-term kinetic chain dysfunction and accelerated degeneration driven by decades of compensatory biomechanical loading. Two geriatric subjects with a history of AIS and chronic pain presented to a private chiropractic clinic. Both underwent a multimodal non-surgical spinal rehabilitation program based on the CLEAR Institute protocol. Pre- and post-treatment radiographic measurements and self-reported outcomes were assessed. Both patients demonstrated clinically meaningful reductions in pain and measurable improvements in sagittal spinal alignment following treatment. These cases suggest that in geriatric patients with AIS, chronic deficits may be more closely related to kinetic chain dysfunction and compensatory degeneration than to the primary scoliotic curve. A non-surgical, multimodal rehabilitation approach targeting global spinal alignment can yield significant clinical improvement. Larger prospective studies are needed to evaluate this hypothesis further.