Spinal Manipulative Therapy for Moderate-to-Severe Adolescent Idiopathic Scoliosis: A Randomized Controlled Trial

LIU Chen; WU Ye-qi; WANG Kai-qi; WEN Ya; LI Qiu-shuang; CHEN Xiao-min; TANG Ding; DU Hong-gen; CHEN Shao

doi:10.1007/s11655-025-4228-8

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Spinal Manipulative Therapy for Moderate-to-Severe Adolescent Idiopathic Scoliosis: A Randomized Controlled Trial

Original Article | Updated：2026-08-04

- Spinal Manipulative Therapy for Moderate-to-Severe Adolescent Idiopathic Scoliosis: A Randomized Controlled Trial
- Spinal Manipulative Therapy for Moderate-to-Severe Adolescent Idiopathic Scoliosis: A Randomized Controlled Trial
- 中国结合医学杂志（英文版） 2026年32卷第5期页码：387-395
- Affiliations：
  
  Tuina Department, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou ( 310006), China
- Author bio：
  
  Dr. CHEN Shao, E-mail: 20163472@zcmu.edu.cn
- Funds：
  
  Zhejiang Provincial "Pioneer" and "Leading Goose" R&D Program(2024C03182);Zhejiang Provincial "Pioneer" and "Leading Goose" R&D Program(2022C03101);Major Project of the Science and Technology Department of the National Administration of Traditional Chinese Medicine and Administration of Traditional Chinese Medicine of Zhejiang Province Collaborative Technology Program(2023017427);Zhejiang Provincial Traditional Chinese Medicine Science and Technology Program—Modernization Initiative(2022ZX015);Zhejiang Provincial Traditional Chinese Medicine Science and Technology Program Project(2024ZL450);Zhejiang Provincial Traditional Chinese Medicine Science and Technology Program Project(2023ZL377);Research Project of Zhejiang Chinese Medical University(2022JKJNTZ22)
- DOI：10.1007/s11655-025-4228-8
  中图分类号：
- 录用：2025-08-04，
  
  网络首发：2025-12-22，
  
  纸质出版：2026-05
- Accepted：
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LIU Chen, WU Ye-qi, WANG Kai-qi, 等. Spinal Manipulative Therapy for Moderate-to-Severe Adolescent Idiopathic Scoliosis: A Randomized Controlled Trial[J]. 中国结合医学杂志（英文版）, 2026,32(5):387-395.

LIU Chen, WU Ye-qi, WANG Kai-qi, et al. Spinal Manipulative Therapy for Moderate-to-Severe Adolescent Idiopathic Scoliosis: A Randomized Controlled Trial[J]. Chinese Journal of Integrative Medicine, 2026, 32(5): 387-395.
LIU Chen, WU Ye-qi, WANG Kai-qi, 等. Spinal Manipulative Therapy for Moderate-to-Severe Adolescent Idiopathic Scoliosis: A Randomized Controlled Trial[J]. 中国结合医学杂志（英文版）, 2026,32(5):387-395. DOI： 10.1007/s11655-025-4228-8.

LIU Chen, WU Ye-qi, WANG Kai-qi, et al. Spinal Manipulative Therapy for Moderate-to-Severe Adolescent Idiopathic Scoliosis: A Randomized Controlled Trial[J]. Chinese Journal of Integrative Medicine, 2026, 32(5): 387-395. DOI： 10.1007/s11655-025-4228-8.

摘要

Abstract

Objective:

To investigate the role of spinal manipulative therapy (SMT) in preventing progression and reducing the need for surgery in moderate-to-severe adolescent idiopathic scoliosis (AIS).

Methods:

This randomized controlled clinical trial was conducted at the First Affiliated Hospital of Zhejiang Chinese Medical University between January 1

2022

and December 31

2023. Overall

118 AIS patients were randomly divided into 2 groups by simple randomization: one receiving SMT combined with brace treatment (SMTB group

59 participants

SMT was given twice weekly

brace was worn for 23 h per day) and the other receiving brace treatment alone (BA group

59 participants

brace was worn for 23 h per day). The primary outcome measure was the success rate after 12-month treatment. The secondary outcomes related to scoliosis

including the Cobb angle

angle trunk rotation (ATR)

and Scoliosis Research Society-22 (SRS-22) score were measured. All the above indicators were subjected to subgroup analysis based on the degree of scoliosis (moderate and severe). Adverse events were observed and recorded.

Results:

Modified intention-to-treat analyses included 112 participants (SMTB group and BA group each had 56 participants

101 girls and 11 boys; 15.11±1.69 years). The success rate was significantly higher in the SMTB group [78.6% (44/56)

]

than in the BA group [51.8% (29/56)

0.01

]

. Among the secondary outcomes

SMTB group was more effective than BA group in reducing the Cobb angle (difference

–3.93; 95% confidence interval [CI

]

–6.11 to –1.74

0.05); SMTB group showed a greater reduction in ATR compared to BA group (difference

–2.34; 95% CI

–3.46

–1.22

0.05) and demonstrated superior efficacy to BA in improving SRS-22 score (difference

6.57; 95% CI

4.55 to 8.59

0.05). Subgroup analysis showed that SMT had similar efficacy in the treatment of moderate and severe AIS. Safety analyses did not differ significantly between the two groups (

0.05).

Conclusion:

SMT appears to be safe and beneficial for moderate-to-severe AIS. (Trial registration No. NCT06648005)

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