Wednesday, April 14, 2010

Full Spine Radiography

Whether an X-ray examination is needed or not is by necessity and by responsibility the judgment of the doctor based on clinical finding and need for further diagnostics. Whether sectional views are chosen or full spine the criteria is the same, medical necessity[ ].  The use of full spine x-rays falls under two broad categories: First, pathology, and Second, analysis.

The use of full spine radiographs is of value when clinical findings indicate multiple levels of spinal involvement [i.e. cervical, thoracic, lumbo-pelvic]. [ ] Full spine radiographs are considered to be of diagnostic quality[ ], with less radiation exposure to the patient [with current technology, exposure factors, film speed, shielding etc] compared to sectionals of the multiple levels involved[  ].

The analysis of the full spine films ranges from the medical radiology’s analysis of scoliosis and different perimeters to the different chiropractic line analysis systems [ ]. There are different studies that have looked into the validity of the different marking systems with mixed results [  ]. The controversies that exist point to the need for further research. Developing an understanding of the complexity of the spine and its many compensatory changes disserves chiropractic full attention. Full spine radiographs offers one of the unique views to study this challenging and complex structure in total. [ ]

Tylor JAM. Full-sipne radiography: a review. J Manipulative Physiol Ther 1993: 16:460-474

Phillips RB. An evaluation of chiropractic x-rays by the diplomate members of the American Chiropractic Board of  Roentenology. ACA J Chiro 1980: 14:S80-S88

Hardman LA, Henderson DJ. Comparative dosimetric evaluation of current techniques in chiropractic full-spine and sectional radiography. Manipulative Physiol Ther 1981; 25:141-145

Hildebrant RW. Chiropractic spinography. 2nd ed. Baltimore; williams&Wilkins, 1985.

Peterson C, Gatterman MI, Wei T. Chiropractic radiography. In;Gatterman MI, ed chiropractic management of spine related disorders. Baltimore: Williams&Wilkins, 1990:90-110

Plaugher G, Hendricks AH. The inter- and intraexaminer reliablity of the Gonstead pelvic marking system. J Manipulative Physiol Ther 1991; 14:503-508.

Plaugher g, Hendricks AH, Doble RW, Araghi HJ, Bachman TR, Hoffart VM. The effects of patient positioning on radiographically evaluated static configurations of the pelvis. Proceedings of the 1991 Conference on Spinal Manipulation, VA 1991.

Hildebrandt RW. Chiropractic spinography and postural roentenology-part 2 ; histroy of development. J Manipulative Physiol Ther 1981; 4:191-201.

Nelson RD. The APFS x-ray veiw. ACA J Chiro 1980; 14:S39-41.

2 comments:

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