A recent paper by Hazel Jenkins and colleagues* attempts to present ‘Current evidence for spinal X-ray use in the chiropractic profession.’ Unfortunately, the review represents an author opinion, ‘red flag only’ guideline consistent with the practice of medicine, not chiropractic.
In detail, we critically analyze the inappropriate and extensive use of selected medical references (i.e. for the practice of general medicine), the neglect of essential and important evidence that must be considered for a full and balanced discussion of chiropractic X-ray use, and erroneous statements in contradiction with the expansive understanding of spinopelvic biomechanical parameters that has occurred over the past 15 years and the fact that these critical parameters must be assessed by routine full-spine radiography.
The concept that spine and postural displacements of a patient impacts their health and wellbeing is a well framed evidence-based practice in the spine literature. Specific, contemporary chiropractic approaches, like contemporary spinal surgery techniques, can improve postural faults and restore normal function and wellbeing.
In the end, the conclusions made by Jenkins et al. are recycled medical practice imaging guidelines for ‘red flags’ only, are representative of a one-sided debate, and are not an accurate assessment of X-ray use for the practice of evidence-based contemporary chiropractic spine care.
To be valid, future chiropractic guidelines must include a consideration of the assessment of the critical spinopelvic parameters and the use of contemporary chiropractic methods used to correct these spinal subluxation deformities as detailed in this critique.
* Jenkins HJ, Downie AS, Moore CS, French SD. Current evidence for spinal X-ray use in the chiropractic profession: A narrative review. Chiropr & Manual Ther. 2018 ;26(48):1-11.
Author keywords: X-ray guidelines, evidence-based practice, chiropractic, spinopelvic parameters, subluxation
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