Spinal X-Ray Imaging: Risks vs Benefits

This week from Dr. Cerami and Utah Sports and Wellness

From:Dose-Response: An International Journal, June 2018

Quick Summary:

Chiropractic therapy realignment of the structure of the spine can address a wide range of pain, muscle weakness and functional impairments. To improve diagnosis and reduce the use of inappropriate treatment, spinal X-rays are essential. While there is much misinformation about X-ray radiation, the radiation employed for a plain radiograph is very low, about 100 times below the threshold dose for harmful effects. Rather than increasing risk, such exposures can likely stimulate the patient’s own protection systems and results in beneficial health effects.

Abstract:

To remedy spine-related problems, assessments of X-ray images are essential to determine the spine and postural parameters. Chiropractic/manual therapy realignment of the structure of the spine can address a wide range of pain, muscle weakness, and functional impairments. Alternate methods to assess such spine problems are often indirect and do not reveal the root cause and could result in a significant misdiagnosis, leading to inappropriate treatment and harmful consequences for the patient. Radiography reveals the true condition and alignment of the spine; it eliminates guesswork. Contemporary approaches to spinal rehabilitation, guided by accurate imaging, have demonstrated superiority over primitive treatments. Unfortunately, there are well-meaning but misguided activists who advocate elimination or minimization of exposures in spine radiography. The radiation dose employed for a plain radiograph is very low, about 100 times below the threshold dose for harmful effects. Rather than increasing risk, such exposures would likely stimulate the patient’s own protection systems and result in beneficial health effects. Spine care guidelines need to be revised to reflect the potential benefits of modern treatments and the lack of health risks from low X-ray doses. This would encourage routine use of radiography in manual spine therapy, which differs from common pharmacologic pain relief practice.

These authors also note:

• “Imaging of the spine is an essential element of modern chiropractic and manual therapy.”
• “Radiography of a standing patient provides important spine/posture data, such as segmental and total angles of curvature, sagittal balance and degenerative processes.”
• “Only X-rays can detect the precise spinal coupling patterns present in assessing craniovertebral syndromes such as forward head translation, lumbar spine disorders and to discriminate between true scoliosis and pseudo scoliosis.”
• “Since low doses of radiation stimulate many protective systems, including the immune system, it is very unlikely that low-level radiation causes more damage than benefit”
• “Damage to molecules and cells from low doses of radiation can hardly be observed, while protective mechanisms can be readily seen and quantified.”
• “Concerns about the risk of cancer from chiropractic radiography are baseless because the dose of an X-ray normally does not exceed about 2-3 mGy for a lumbar image, which is more than 100 times lower than the does threshold for radiogenic cancer.”