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Are Chiropractic X-rays Really Necessary?
Dr. Don Parkerson, Jr.
Many in today’s mainstream
media would have you believe that chiropractors only take x-rays to make more
money. Is this true? Let me tell you exactly why our clinic takes x-rays
on every patient, and more importantly, how our clinic uses those x-rays to
directly affect your health and quality of life.
The Misinformation
Station
In the mid 90s, the magazine Consumer Reports put out a hatchet-piece
on the chiropractic profession. In its
summary of recommendations to their readers, they advised to “never see a
chiropractor who requires x-rays as part of their treatment.”
I was also driving back from
lunch one afternoon listening to a local talk-radio guy. As luck would have it, chiropractic came up
as a topic. This host also mentioned
that chiropractors take x-rays to pad their bills and increase revenues. His advice: chiropractors are ok, but don’t
go to the ones who require x-rays.
The Real Truth
In my Dad’s South Georgia
chiropractic clinic, he had an old sign from the 70’s posted at his front
desk. “To see is to know . . . not to see is to guess . . . and we won’t guess
about your health.” That may be a
little bit cliché, but the point is true.
When you are working with the spine, the only
accurate way to determine a proper course of treatment is to see exactly what
you’re dealing with. That is
particularly true for the specialized upper cervical procedure that our clinic
practices.
In the Orthospinology
procedure, the chiropractic adjustment is made via instruments according to a
mathematical formula that is calculated from three-dimensional x-rays of the
neck. Those initial three x-rays are the
foundation by which our entire patient care is based.
Not only must those films be
taken on each patient, they must be perfect both in form and analysis for us to
achieve optimal results. As such, our
clinic goes to great lengths to ensure that our Chiropractic Radiology Techs
are well-skilled in taking precise upper cervical x-rays.
Each particular x-ray has
vital information and measurements of spinal misalignment that lead to the
mathematical formula by which our patients are adjusted. After our patients’ initial adjustment, we
then re-take two of the x-rays to determine how well our adjustment
worked. The before and after x-rays are
referred to as “Pre” and “Post” x-rays and we show each patient their Pre/Post
films on their 2nd visit to our clinic.
The three x-rays that we use
in our Orthospinology procedure are the:
1.
Lateral Cervical
2.
Nasium
3.
Vertex
In addition to those 3 views,
we often take an x-ray of the lower back or mid-back if that is the area of our
patient’s primary problem. I will
discuss each of these views in depth below.
The Lateral Cervical
The lateral cervical x-ray is
the most standard neck x-ray and is a look at the spine from the side. This view is taken by virtually all
chiropractic and medical clinics and is helpful in diagnosing any of the following:
·
Lack of normal
cervical curvature, or a reversed cervical curve
·
Disc
degeneration, bone spurring, and/or other arthritic changes
·
Developmental
abnormalities in the neck
·
Tumors, lesions,
fractures, or other conditions that might 
indicate a more serious underlying condition
The lateral cervical also
provides two distinct benefits to our upper cervical procedure:
1.
Notice the line
drawn along the 1st cervical vertebra (C1 – Atlas) in the film to
the right. That line is the precise
angle by which upper cervical chiropractors must take film #2, the nasium. Without knowing the exact angle of a
patient’s C1 vertebra, taking the nasium film is impossible.
2.
Look slightly
beneath the C1 vertebra and you will see 2 white dots. These are lead BB’s placed on our patient’s
ears before taking the film. The purpose
of the BB’s is to help us find the precise location of the patient’s C1
vertebra when making our adjustment.
The Nasium
The nasium x-ray is a
front-to-back view of the head and neck.
It is the film that provides the majority of the spinal measurements in
our Orthospinology analysis and is also the view that shows the most dramatic
before and after changes.
From the nasium, we get 4 of
the 5 misalignment measurements and two-thirds of our mathematical
formula. The 4 measurements are the
following:
1.
C1 (AT) – The
right or left misalignment of the C1 vertebra.
This factor determines which side of our patient’s neck that we
adjust. Measured in degrees.
2.
C2 Odontoid (OD)
– The rotation or twisting movement of the front of the C2 vertebra. Measured in millimeters.
3.
C2 Spinous
Process (SP) – The rotation or twisting movement of the back of the C2
vertebra. Measured in millimeters.
4.
Lower angle
(C5-C7) – The right or left misalignment of the lower part of the neck. Measured in degrees.
Each of those 4 measurements
is represented by a number on the nasium analysis. In a perfect spine, all 4 of those numbers
would be zero. Once the measurements are
determined on the patient’s original film, the goal of the Orthospinology
adjustment is to reduce those numbers to zero, or as close as possible.
The diagrams below demonstrate
the Orthospinology analysis on the nasium film.
The diagram to the left represents a “Pre,” or before x-ray, and the one
to the right shows the goal of our “Post,” or after x-ray.
Below, you will see a set of 3
nasium film that were taken in our clinic.
The 1st one (far left) was taken before this patient’s 1st
adjustment. Notice the 4 different numbers
that are measured on the nasium film.
Each represents a particular part of this patient’s spine that is
misaligned.
The 2nd picture
(middle) was taken immediately after this patient’s 1st
adjustment. Notice that the numbers are
closer to zero, but still quite substantial.
That indicates that an improvement was definitely achieved on his first
adjustment, but additional adjustments would likely be required to achieve
optimal results.
The 3rd nasium (far
right) was taken 10 days after the initial visit. This film shows a more dramatic change in
alignment and the numbers are much closer to zero. This qualified as a satisfactory spinal
correction and no further x-rays were taken.
The Vertex
The 3rd view that our
clinic takes on each patient is the vertex view. The vertex is an above-down view of the top
of the spine and provides the other 1/3 of our Orthospinology adjusting
calculation.
The purpose of the vertex film
is to measure the rotation of the C1 vertebra in the spine. This is measured as:
·
Anterior – C1
has rotated forward on the side we adjust
·
Posterior – C1
has rotated backward on the side we adjust
Study these 2 vertex films.
The vertex on the left was
taken prior to this patient’s 1st adjustment. Her C1 had rotated 1.75 degrees Anterior on
the left side. The second film was taken
immediately after her 1st adjustment and shows that her C1 rotation
corrected 100%.
Other X-ray Views
If a patient’s primary condition is their mid or
lower back, we will generally take an x-ray of that problem region.
To the right are 2 examples of
such film. The first is a thoracic (mid
back) view and the second is a lumbar (lower back) view.
From these types of x-rays, we
can determine if a patient has any of the following:
·
Scoliosis, or
abnormal curvature of the spine
·
Fractures,
tumors, or any abnormal spinal development that might affect that patient’s
progress under our care.
For further information on this topic, you may contact
Dr. Parkerson at 770.952.5353, by email at Parkerson@humberparkerson.com,
or visit our clinic on the web at www.HumberParkerson.com.
The Highest Level is the monthly e-mail newsletter of
the Humber Parkerson Clinic and is designed to empower our patients and the
general public to make informed decisions on issues of nutrition, lifestyle,
and spinal care. To receive The Highest
Level each month, e-mail your request to HighestLevel@humberparkerson.com.
© Humber Parkerson
Clinic 2006
October 2006 issue of The Highest Level
