Repeat Radiography in Monitoring Structural Changes in the Treatmentof Spinal Disorders in Chiropractic and Manual Medicine Practice: Evidence andSafety

摘要

There is substantial evidence for normal relationships between spine and posturalparameters, as measured from radiographs of standing patients. Sagittal balance,cervical lordosis, thoracic kyphosis, lumbar lordosis, pelvic tilt, and the morecomplex understanding of the interrelations between these essential componentsof normal stance have evolved to where there are known, established thresholdsfor normalcy. These spinal parameters are reliably measured from X-ray imagesand serve as goals of care in the treatment of spine and postural disorders.Initial and follow-up spinal imaging by X-ray is thus crucial for the practiceof contemporary and evidence-based structural rehabilitation. Recent studieshave demonstrated that improvement in the spine and posture by nonsurgicalmethods offers superior long-term patient outcomes versus conventional methodsthat only temporarily treat pain/dysfunction. Low-dose radiation from repeatedX-ray imaging in treating subluxated patients is substantially below the knownthreshold for harm and is within background radiation exposures. Sincealternative imaging methods are not clinically practical at this time, plainradiography remains the standard for spinal imaging. It is safe when used in arepeated fashion for quantifying pre–post spine and postural subluxation anddeformity patterns in the practice of structural correction methods bychiropractic and other manual medicine practices.