When you look at the cost of the CLEAR Institute scoliosis treatmentTM program, it certainly seems like a lot of money. If you call some of the CLEAR InstituteTM clinics, you’ll find out that the exact prices will vary, because each clinic sets their own prices. If you’re traveling from out of town for the intensive treatment (which is two visits each day, each visit lasting about 3 hours), most clinics charge around $3,000 for one week of care – not including the cost of travel, lodging, and food. Patients who live near a CLEAR InstituteTM clinic and receive care on a regular basis pay less, although the total cost will vary from person to person, depending upon the severity of the curvature and what treatment is required.
However, it’s not just about cost – it’s also about value. In order to understand why the treatment costs so much, you have to compare it to the other treatment options available.
With a mild case of scoliosis, the treatment fees for the CLEAR Institute methodTM are generally less than with a severe case of scoliosis. The other option besides CLEAR is doing nothing; observation only. However, even observation only has its costs – the cost of doctor visits, x-rays, and exams. According to research, the average cost of simply monitoring a mild curve for one year is $3,386.25, and the only benefit to observation is that you know what’s happening.1 There are no recorded cases of scoliosis being cured by observation.
Comparing one year of doing nothing to one week of intensive treatment, the cost of one week of intensive treatment is less. The potential benefits are walking away with a Cobb Angle that is less than what it was before (sometimes even less than 10 degrees, thus technically no longer considered a scoliosis), and knowing what exercises & therapies to do at home to maintain and improve upon the correction. If the patient does their exercises faithfully and the correction can be maintained until skeletal maturity, research has shown that the chance that the scoliosis will worsen in adulthood is drastically reduced.2 The real benefit of CLEAR Institute scoliosis treatmentTM, then, is that a person with a mild scoliosis may never need to worry about wearing a brace or undergoing surgery, or suffering pain or limitations because of their scoliosis later in life.
In this light, it really doesn’t make much sense why someone would choose to merely observe and do nothing about their scoliosis, when they could instead actually reduce the chances of their scoliosis getting worse – and pay less than if they chose to do nothing.
With a moderate case of scoliosis, scoliosis brace treatment is introduced as a treatment option. It must be recognized that the goal of scoliosis bracing is merely to stabilize a curve that is progressing; back bracing does not offer any long-term benefit or hope of correction. The cost of a scoliosis brace varies widely depending upon the design, but generally ranges from $5,000 to $10,000. This does not include the cost of the doctor fitting the brace, x-rays taken in the brace, or other associated fees – which, according to research, average around $10,836 annually.1 So a patient being orthopedically braced faces an initial investment of $5,000 or more, plus $10,000 each year they wear the scoliosis brace. If, at the end of the back bracing period, their curve has progressed 5 degrees, this is then considered a success???
It’s important also to consider the ramifications of wearing a scoliosis brace – the time involved, and the emotional impact. Back Bracing is typically recommended for 23 hours out of the day; compliance, understandably, has been shown to be very poor.3 The psychological trauma of wearing a scoliosis brace during the formative middle school or high school years can also be very real, and can leave invisible scars that last for a lifetime.4
The CLEAR InstituteTM method for scoliosis recommends that someone with a moderate case of scoliosis purchase a Scoliosis Traction ChairTM to use at home; this costs about $4,000. Generally they will use this chair twice a day for 30 minutes each time; one hour a day, instead of 23 hours. There’s no risk of emotional trauma; the chair is only used for a short time, not in a public setting but in the privacy of your own home, and you can watch television or play video games to help the time pass faster. If the scoliosis is corrected to the point where the Scoliosis Traction ChairTM is no longer needed, it can be sold back to the company and a portion of the initial cost is returned to you. This isn't possible with a scoliosis brace, where each back brace is custom designed and fitted for one individual patient. Compliance with the chair tends to be much greater than it is with an orthopedic brace, because the time required is much less, and there is no shame or social isolation associated with using it.
A moderate case of scoliosis that travels to a CLEAR InstituteTM clinic from out of town may require two weeks of intensive treatment; this treatment regimen might be repeated again later on. The cost of two weeks of treatment averages around $5,000 (the initial examination is more expensive than later visits, so the cost is front-loaded). So, someone with a moderate case of scoliosis might be spending $10,000 a year on CLEAR Institute scoliosis treatmentTM – generally what they would be paying to undergo scoliosis brace treatment. They’ll be spending a little bit less on the Scoliosis Traction ChairTM than they would for a back brace.
The value of CLEAR InstituteTM scoliosis treatment in this case is as obvious as it is with a mild case of scoliosis. Instead of hoping for the curve to stay the same, you’re hoping for the curve to get better. The financial costs are similar, but the emotional costs are much less. Instead of being motivated by the fear that if you don’t wear your back brace, your curve will get worse, you’re motivated by the hope that if you use the chair every day, your curve will be much better. If you do, and it does, you are rewarded by being able to reclaim some of the money you spent on the Scoliosis Traction ChairTM.
With a severe case of scoliosis, surgery enters the picture. The cost of scoliosis surgery varies from region to region, but can be as high as $152,637.5 This does not include the cost of recovery time in the hospital, time lost from school or work – or the cost of revision surgery or treating any unforeseen complications. It should be expected that, when a healthcare procedure costs as much as a modest home, it has been thoroughly researched and proven to be effective. Unfortunately, only the first is true. There is no definitive long-term research that proves living with a fused, straight spine is superior to living with a flexible, curved spine. Each generation of new spinal implants evolved because of problems with the previous systems; these new systems allow better correction, but also result in a higher rate of complications. Whether it’s Harrington, Colorado, Cotrel-Dubousset, TSRH, or Universal Spine System, regardless of the type of instrumentation used, the underlying premise behind every spinal fusion surgery for scoliosis is identical; immobilization and solid bony fusion of the spine, resulting in a permanent loss of spinal flexibility and range of motion. There are never any guarantees that additional surgeries will not be needed, or that pain levels will be reduced or that cosmetic appearance will be improved by scoliosis surgery.
One of the primary goals of CLEAR InstituteTM scoliosis treatment is to ensure that the patient achieves the best possible quality of life and functions at the highest possible level. With scoliosis surgery, this is considered of secondary importance; the main goal is to make the spine look straighter on an x-ray. There is no correlation between this outcome and reductions in pain, improvements in lung function, increases in quality of life, or better physical function.
When an individual with severe scoliosis presents for CLEAR InstituteTM scoliosis treatment, it’s highly likely that the patient will be making a long-term commitment to care. Again, fees vary, but let’s imagine a hypothetical situation where a patient spends about $200 per visit, and comes in 50 times in one year. That patient would have spent around $10,000. If each visit is three hours, the hourly fee is just over $60 per hour – roughly the same fee that many massage therapists charge for an hour-long massage. This is a perfect example of how costs may mislead, but comparing the cost of one treatment to another – and what you should expect to receive for your money – leads to a better understanding of the real value of each therapy.
So while $10,000 may seem like a high cost, its value compared to surgical intervention is significant. One study found that 16.7 years after spinal fusion, 40% of patients were legally defined as permanently handicapped (it is rather ironic that scoliosis surgery is often presented as a patient’s only option to avoid permanent disability). Imagine you had a check for $150,000 that you had to spend only on healthcare, and ask yourself if you would choose to undergo an operation that may leave you worse off fifteen years from now, or spend your money on fifteen years of you & a CLEAR InstituteTM doctor working together to correct your scoliosis naturally.
Before anyone can fully accept this comparison, it’s reasonable at this point to ask, where is the long-term research on CLEAR’s methods? The cold hard truth is that, if there was any real interest on the part of the orthopedic community of finding a more cost-effective, less invasive method of helping people with scoliosis to lead active, pain-free lives without back bracing or scoliosis surgery, there would be extensive resources devoted to publishing this research. However, the vast majority of all scoliosis research done today is on the topic of surgical intervention; less than 5% of the articles published focus on finding alternatives or providing non-surgical alternatives. In the absence of the infrastructure & funding to implement a well-designed, independent study comparing CLEAR Institute scoliosis treatmentTM to scoliosis surgery, it is the responsibility of the patient to be their own advocate, and rely upon their own judgment, until such a time as when someone decides to put surgery to the test, and compare the long-term outcomes between surgically-treated patients with CLEAR InstituteTM-treated patients.
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1) Yawn et al: The estimated cost of school scoliosis screening, Spine 2000 Sep 15;25(18):2387-91.
2) Weinstein et al: Curve progression in idiopathic scoliosis. J Bone Joint Surg Am 1983;65:447-55.
3) Vandal S, Rivard C-H, Bradet R: Measuring the compliance behaviour of adolescents wearing orthopedic braces. Issues Compr Pediatr Nurs 1999, 22(2–3):59-73.
4) Saccomani L, Vercellino F, Rizzo P, Becchetti S: Adolescents with scoliosis, psychological and psychopathological aspects. Minerva Pediatrica 1998, 50(1–2):9-14.
5) Daffner et al: Geographic and demographic variability of cost and surgical treatment of idiopathic scoliosis. Spine 2010 May 15;35(11):1165-9.
6) Gotze et al: Long-term results of quality of life in patients with idiopathic scoliosis after Harrington instrumentation and their relevance for expert evidence. Z Orthop Ihre Grenzgeb 2002 Sep-Oct;140(5):492-8.