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Advanced Imaging & Chiropractic

CBCT, Chiropractic, upper cervical

Posterior view of the upper cervical region.

Here is a recent publication from the Journal of Upper Cervical Chiropractic Research by researchers Dr. Jonathan Verderame and Dr. Jake Hollowell. What makes this article impressive is that the patient was evaluated using the cone beam CT (CBCT) technology in a chiropractic setting. This is really unique and, as the article states, “the utilization of CBCT in a clinical chiropractic setting has not been explored.”

While CT is said to be an ‘extremely valuable tool’ that is a ‘widely available noninvasive modality for evaluating abnormalities of the spine’ it has never been used for bio-mechanical assessment of the occipital-atlanto-axial misalignment for chiropractic analysis.

The intervention that was provided to a 75-year-old patient that suffered from chronic migraines was a specialty in chiropractic known as Blair Upper Cervical Technique, or Blair for short. Traditionally this method of chiropractic requires various x-ray images to evaluate the structure and mechanics that are involved in the upper cervical region of the spine. With the CBCT technology, a chiropractor will not only be able to assess the alignment of the vertebrae but also be able to identify small and significant congenital or acquired anomalies that may effect the clinical recommendations of the patient.

CBCT unit by Scanora

CBCT unit by Scanora

This is a fairly new and highly specialized field in chiropractic. The CBCT is more commonly found in a dentist or orthodontist office and used to evaluate structures of the jaw and teeth. While traditional chiropractic care is excellent in caring for migraines and headaches, the research confirmed that the patient only needed two corrections in the 10 week evaluation period.  The use of such equipment in chiropractic specialties has implications that a patient may see greater improvement with less interventions. There is a potential to reach individuals with more complex conditions.

The article address the risk of radiation and states that the CBCT uses “between 98.5% and 76.2% [less radiation] compared to traditional CT.” The way this is done is by “pulsing” the radiation so the patient is not subject to it during the whole procedure. With reduced exposure to radiation and improved image for evaluation, this modality for examining the spine may prove useful in certain cases.

The drawbacks might include the cost to both the practitioner and the patient, specialized training in the use of the imaging software and patient exposure to radiation. As with everything, there’s a risk vs benefit factor.

Read full article

Reference

  • Verderame, Johnathan and Hollowell, Jake. “Cone-beam Computerized Tomography for the Bio-mechanical Assessment of the Occipito-atlanto-axial Articulation in a 75-year-old Woman with Migraines Undergoing Blair Technique” Journal of Upper Cervical Chiropractic Research. July 2013.
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