The rise and fall of lateral electrical surface stimulation (LESS) through the lens of SRS archives

Lateral electrical surface stimulation (LESS), commercially known as the ScoliTron™, emerged in the late 1970s as a noninvasive alternative to bracing for adolescent idiopathic scoliosis. Early clinical reports generated considerable enthusiasm and adoption, but the technique was ultimately abandoned. This study examined the rise and fall of LESS through a combined analysis of the Scoliosis Research Society (SRS) archives and published literature, with the goal of understanding factors that influence the adoption, evaluation, and abandonment of innovation in scoliosis care.

A structured historical review was conducted using archival materials from the Scoliosis Research Society (SRS), including meeting abstracts, audiovisual records, and correspondence. Archival data were independently screened and extracted by two reviewers. In parallel, a focused literature review was performed in accordance with PRISMA guidelines using PubMed and Ovid MEDLINE, with independent screening and full-text assessment by two reviewers.

The archival review identified 24 SRS abstracts related to LESS. The literature search identified 50 records, of which 26 underwent full-text review and 12 met inclusion criteria. Early reports suggested short-term curve stabilization in selected patients, leading to increased clinical adoption. However, larger studies with longer follow-up demonstrated inconsistent outcomes, including continued progression in skeletally immature patients, variable compliance, device related complications, and high failure rates. Comparative studies consistently demonstrated outcomes inferior or, at best, equivalent to bracing, with no convincing evidence that LESS altered the natural history of scoliosis. Archival materials further revealed evolving professional perspectives and concerns that were not always captured in the published literature.

The history of LESS illustrates how promising innovations can achieve widespread acceptance before sufficient evidence is available to support their long-term effectiveness. The SRS archives provide unique insight into the scientific, clinical, and cultural factors that shaped both the adoption and eventual abandonment of this technology. Beyond the story of LESS, this analysis highlights the value of historical archives in understanding the evolution of scoliosis care and informing future innovation.