Clinical Research

Evaluation of the assumptions used to derive an ideal normal cervical spine model.

OBJECTIVES: To evaluate the accuracy of anatomical assumptions made to derive a geometrical, ideal, normal model of the upright, static, sagittal cervical spine, to make comparisons with other spinal models and to discuss the implications of a normal cervical model. STUDY DESIGN: (a) Data were collected from 400 lordotic lateral cervical radiographs and compared with the predictions of a geometric normal cervical lordotic model. Angels of intersecting tangent lines, drawn at posterior vertebral body margins, were measured at each disc space and between C2 and C7. Height-to-length ratios and an anterior weight-bearing distance were measured. (b) Literature reviews were obtained through Medline and Chirolars. RESULTS: Modeling: the 400 sample subjects varied from the geometric model by approximately 5%. CONCLUSIONS: Two typical geometric configurations of the cervical spine were identified as a normal circular lordotic arc of 34 degrees and an ideal normal of 42 degrees. Literature reviewed establishes cervical lordosis as a desirable clinical outcome of care. Harrison DD, Janik TJ, Troyanovich SJ, HarrisonDE, Colloca CJ. J Manipulative Physiol Ther. 1997 May;20(4):246-56.

Increasing the cervical lordosis with chiropractic biophysics seated combined extension-compression and transverse load cervical traction with cervical manipulation: nonrandomized clinical control trial.

OBJECTIVES: To study whether a seated, retracted, extended, and compressed position would cause tension in the anterior cervical ligament, anterior disk, and muscle structures, and thereby restore cervical lordosis or increase the curvature in patients with loss of the cervical lordosis. CLINICAL FEATURES: 30 preselected patients, were treated for the first 3 weeks of care using cervical manipulation and cervical extension-compression traction. Pretreatment and posttreatment Visual Analogue Scale (VAS) pain ratings were compared along with pretreatment and posttreatment lateral cervical radiographs analyzed. Results are compared to a control group of 33 subjects receiving no treatment and matched for age, sex, weight, height, and pain. RESULTS: Control subjects reported no change in VAS pain ratings and had no statistical significant change in segmental or global cervical alignment on comparative lateral cervical radiographs repeated an average of 8.5 months later. For the traction group, VAS ratings were 4.1 pretreatment and 1.1 posttreatment. On comparative lateral cervical radiographs repeated after an average of 38 visits over 14.6 weeks, 10 angles and 2 distances showed statistically significant improvements, including anterior head weight bearing (mean improvement of 11 mm), Cobb angle at C2-C7 (mean improvement of -13.6 degrees ), and the angle of intersection of the posterior tangents at C2-C7 (mean improvement of 17.9 degrees ). Twenty-one (70%) of the treatment group subjects were followed for an additional 14 months; improvements in cervical lordosis and anterior weight bearing were maintained. CONCLUSIONS: Chiropractic biophysics (CBP) technique's extension-compression 2-way cervical traction combined with spinal manipulation decreased chronic neck pain intensity and improved cervical lordosis in 38 visits over 14.6 weeks, as indicated by increases in segmental and global cervical alignment. Anterior head weight-bearing was reduced by 11 mm; Cobb angles averaged an increase of 13 degrees to 14 degrees; and the angle of intersection of posterior tangents on C2 and C7 averaged 17.9 degrees of improvement.HarrisonDE, Harrison DD, Betz JJ, Janik TJ, Holland B, Colloca CJ, Haas JW. J Manipulative Physiol Ther. 2003 Mar-Apr;26(3):139-51.

Cervical kyphosis is a possible link to attention-deficit/hyperactivity disorder - ADHD.

OBJECTIVE: To discuss the case of a patient who was diagnosed with attention-deficit/hyperactivity disorder (ADHD) by a general practitioner and was treated with chiropractic care. CLINICAL FEATURES: A 5-year-old patient was diagnosed with ADHD and treated by a pediatrician unsuccessfully with methylphenidate (Ritalin), Adderall, and Haldol for 3 years. The patient received 35 chiropractic treatments during the course of 8 weeks. A change from a 12 degrees C2-7 kyphosis to a 32 degrees C2-7 lordosis was observed after treatment. During chiropractic care, the child's facial tics resolved and his behavior vastly improved. After 27 chiropractic visits, the child's pediatrician stated that the child no longer exhibited symptoms of ADHD. The changes in structure and function may be related to the correction of cervical kyphosis. CONCLUSION: The patient experienced significant reduction in symptoms. Additionally, the medical doctor concluded that the reduction in symptoms was significant enough to discontinue the medication. There may be a possible connection that correction of cervical kyphosis in patients with ADHD may produce a desirable clinical outcome. Bastecki AV, HarrisonDE, Haas JW. J Manipulative Physiol Ther. 2004 Oct;27(8):e14.

Prediction of osteoporotic spinal deformity.

STUDY DESIGN: A biomechanical model was developed from full-spine lateral radiographs to predict osteoporotic spinal deformity in elderly subjects. OBJECTIVE: To investigate the biomechanics of age-related spinal deformity and concomitant height loss associated with vertebral osteoporosis. SUMMARY OF BACKGROUND DATA: Vertebral bone loss and disc degeneration associated with aging causes bone and disc structures to weaken and deform as a result of gravity and postural stresses. METHODS: An anatomically accurate sagittal-plane, upright-posture biomechanical model of the anterior spinal column (C2-S1) was created by digitizing lateral full-spine radiographs of 20 human subjects. Body weight loads were applied to the model, after which intervertebral disc and vertebral body forces and deformation were computed and the new spine geometry was calculated. The strength and stiffness of the vertebral bodies were reduced according to an osteopenic aging model and modulus reduction algorithm, respectively. RESULTS: The most osteopenic model (L3 F(ult) = 750 N) produced gross deformities of the spine, including anterior wedge-like fracture deformities at T7 and T8. In this model, increases in thoracic kyphosis and decreases in vertebral body height resulted in a 25.2% decrease in spinal height (C2-S1), an 8.6% decrease in total body height, and a 15.1-cm anterior translation of the C2 spine segment centroid. The resulting deformity qualitatively resembled deformities observed in elderly individuals with osteoporotic compression fractures. CONCLUSIONS: These predictions suggest that postural forces are responsible for initiation of osteoporotic spinal deformity in elderly subjects. Vertebral deformities are exacerbated by anterior translation of the upper spinal column, which increases compressive loads in the thoracolumbar region of the spine. Keller TS, HarrisonDE, Colloca CJ, Harrison DD, Janik TJ. Spine. 2003 Mar 1;28(5):455-62.

 

Anterior thoracic posture increases thoracolumbar disc loading.

OBJECTIVE: Characterize changes in thoracolumbar disc loads and extensor muscle forces following anterior translation of the thoracic spine in the upright posture. CLINICAL FEATURES: Vertebral body geometries (C2 to S1) and the location of the femoral head and acetabulum centroids were obtained by digitizing lateral, full-spine radiographs of 13 men and five women volunteers without previous history of back pain. CONCLUSION: In the absence of external forces, the largest contributor to intervertebral disc (IVD) loads and stresses is trunk muscular activity. In the anterior translated posture, disc loads and stresses were significantly increased for all levels below T9. Increases in IVD compressive loads and shear loads, and the corresponding stresses, were most marked at the L5-S1 level and L3-L4 level, respectively. The extensor muscle loads required to maintain static equilibrium in the upright posture increased from 147.2 N (mean, neutral posture) to 667.1 N (mean, translated posture) at L5-S1. Compressive loads on the anterior and posterior L5-S1 disc nearly doubled in the anterior translated posture. Anterior translation of the thorax resulted in significantly increased loads and stresses acting on the thoracolumbar spine.This posture is common in lumbar spinal disorders and could contribute to lumbar disc pathologies, progression of L5-S1 spondylolisthesis deformities, and poor outcomes after lumbar spine surgery.In conclusion, anterior trunk translation in the standing subject increases extensor muscle activity and loads and stresses acting on the intervertebral disc in the lower thoracic and lumbar regions.HarrisonDE, Colloca CJ, Harrison DD, Janik TJ, Haas JW, Keller TS. Eur Spine J. 2004 May 27.

Chiropractic and geriatrics: a review of the training, role, and scope of chiropractic in caring for aging patients.

"Chiropractors may be well-positioned to play an important role in health promotion, injury and disease prevention, and on geriatric care teams, due to their practice style and holistic philosophy." "Chiropractors, well trained in health assessment, diagnosis, radiographic studies, health promotion, and illness prevention, are well-positioned to provide many primary health-care services to aging patients." "Relative to musculoskeletal care in elderly patients, chiropractic adjustments (spinal manipulative therapy) are recommended by the Agency for Health Care Policy and Research for the care of acute low back pain, and the American Geriatric Society Panel Guidelines for the Management of Chronic Pain state that non-pharmaceutical interventions such as chiropractic may be appropriate."  Killinger LZ. Clin Geriatr Med. 2004 May;20(2):223-35.

The efficacy of adjusting the ankle in the treatment of subacute and chronic grade I and grade II ankle inversion sprains.

In one study 15 of 30 patients were treated for subacute and chronic grade I and grade II ankle inversion sprains with Chiropractic ankle mortise joint adjustments. 15 patients in the placebo group received 5 minutes of detuned ultrasound treatment for 8 treatment sessions spread over a period of 4 weeks. This study indicates that the mortise separation adjustment may be superior to detuned ultrasound therapy in the management of subacute and chronic grade I and grade II inversion ankle sprains. Pellow JE, Brantingham JW. J Manipulative Physiol Ther. 2001 Jan;24(1):17-24.

A brief introduction to the human nervous system.

Your brain and nervous system control the function of every cell, tissue, organ and system of the human body. The brain stem and spinal cord are the primary pathway for nerve impulses to and from the brain. The nerve impulses which travel through these pathways control virtually every action and sensation of the body.

 

Your brain, brain stem and spinal cord are protected by bone. Your skull protects your brain and you spine protects your spinal cord. Your spinal column consists of 24 separately movable bones. There are 7-cervical, 12-thoracic and 5-lumbar vertabrae. At the base of the spinal column are the sacrum and coccyx.

 

Everyday stresses and strains can cause your spinal bones to lose their normal range of motion or normal positions and alignment. This sets of a chain reaction which affects the vertebrae, nerves, muscles, discs, ligaments, tendons and other soft tissues. These changes can result in spinal degeneration called Vertebral Subluxation Degeneration.

 

When spinal joints become stuck or fixated and they are not moving enough, they force other spinal joints to compensate by moving too much. This can distort normal spinal alignment and curves. Sometimes problems in one area on the spine will cause compensatory problems in another area of the spine.

 

Vertebral Subluxations can be caused by physical trauma (birth trauma, poor posture, repetitive motion, car accidents, slips and falls), emotional stress (negative thoughts, unhealthy relationships, stressful work and fear), or chemical imbalances (drugs, alcohol, nicotine, toxins, pollution and unhealthy foods).

 

Chiropractors are the only licensed health care practitioners trained to locate and adjust Vertebral Subluxations.

 

Vertebral Subluxations can be detected by analyzing posture, interpreting diagnostic X-rays, measuring range of motion and other orthopedic and neurologic tests.

 

Correcting a Vertebral Subluxation complex takes time, as does all healing. Vertebral Subluxations interfere with the body's ability to function optimally including Healing, Growing, Thinking, Feeling, Emotions and your Spirit. Vertebral Subluxations are the cause of many of the health concerns that people suffer from every day.

 

At Chiropractic First we are the "Posture Experts." We believe that we provide the finest Chiropractic Biophysics spinal corrective techniques in the world. Our team of professionals developed Posture Massage. Our Chiropractors and Licensed Massage Therapists are continually researching the latest in natural health breakthroughs and bringing this information to our patients and clients. We focus 100% on every patient who walks through our doors and give them all of the care that they need. We listen to the patients needs. We give 100% of our attention to you at all times. Exceeding our patients' expectation is our #1 goal.