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Pre and post X-rays have been important standards of
care in the chiropractic profession for 49 years.
Dr. B.J. Palmer, the "developer of
chiropractic," introduced X-rays to the chiropractic profession in 1911.(1) He stated
it was necessary to X-ray the spine to find vertebral misalignment on a scientific
basis.(2)
In 1946, Dr. John F. Grostic introduced to the
chiropractic profession post X-rays, which were taken immediately after the atlas
adjustment in order to compare them to the pre X-ray taken before the adjustment.(3) He
stated that if pre X-rays showed the vertebral subluxation, then post X-rays should show
that the subluxation was reduced, improved or that it was a non-reducible subluxation.(4)
I began conducting seminars with Grostic in 1952. During
these seminars, no patient would receive adjustments in the occipital-atlas-axis area
unless pre X-rays were taken. All patients were post X-rayed immediately following the
adjustment, and those radiographs were compared to the pre X-rays.
I was an instructor at the John F. Grostic Seminars in
Ann Arbor, Mich., in the late 1950s. After Grostic's death in 1964, we presented atlas
seminars that required pre and post X-rays.
The primary objective of the chiropractic profession is
to find and correct spinal subluxations. This is the one service our profession has to
offer that no other profession offers as a main objective. It is quite common in the
medical profession to post X-ray fractures and luxations to compare with the pre X-rays to
see if they have been reduced and improved.
In the atlas orthogonal programs, the patient must have
three pre cervical X-rays and two post X-rays immediately after the adjustment in the
cervical area. When there are other areas of the body involved, they must be X-rayed in
addition to the five cervical orthogonal X-rays.(5)
Some subluxations reduce better than others, and some
require a fewer number of adjustments. Some maintain their corrected position, but some
remain unstable.
X-Ray Utilization
The typical high and low subluxations usually result
from a single trauma. The atypical subluxation usually results from multiple traumas at
different times or from multiple impacts within one trauma.(6)
Congenital architectural malformations, aberrations and
soft tissue integrity are also primary considerations in cervical spinal stability.
Many patients with atypical subluxations or multiple
traumas will respond favorably to the vectors and formulae to correct the subluxation, and
the symptomatic condition improves dramatically. Sometimes during the course of care, the
subluxations may change to one of the earlier positions that they were in before the
second or third trauma. The only way the doctor can recognize this is when the adjustment
that had been working and improving the patient's condition suddenly becomes ineffective
and does not work.
It is absolutely necessary at this time for the doctor
to take new pre X-rays to see if the subluxation patterns have changed. He must then
formulate new vectors to adjust the patient in the new position, and he must take post
X-rays to document the efficacy of the new adjustment.
Pre and post X-rays have been important standards of
care in the chiropractic profession for 49 years. The doctor of chiropractic orthogonality
is extensively trained in utilizing pre and post X-rays. Care programs involving
procedures executed at the base of the skull are vitally important and must be scientific
and accurate.
Finding and correcting spinal subluxation programs for
chiropractic care and using scientific equipment will not be discontinued or cut short in
any way because of fees, whether paid by the patient or by the insurance company. The
quality of care will not be compromised. Care programs and fees should be explained to the
patient prior to delivery of adjustments.
Conclusion
Pre X-rays are a vital part of the chiropractic
examination. Post X-rays are important to document the efficacy of the chiropractic care
plan. Most chiropractic malpractice insurance companies state: "No X-rays, no
defense."(7)
About the authors:
Roy W. Sweat, D.C., B.C.A.O., a 1950 graduate of Palmer College of Chiropractic,
has been in practice for 35 years and currently manages a clinic in Atlanta, Ga. An
associate professor at Life College, he is a noted author of four books on atlas
orthogonality and
a presenter of specialized seminars on programs
developed by John F. Grostic, beginning in 1960, and on his own atlas orthogonality
program, created in 1981. He has designed an atlas orthogonal computerized X-ray analysis
program, a chiropractic adjusting instrument and X-ray
equipment. Matthew H. Sweat, D.C., B.C.A.O., a 1989 Life
College graduate, is board certified in atlas orthogonality and delivers lectures on the
program. He has completed extensive postgraduate studies of the upper cervical area, and
he is certified in videofluoroscopy. For more information, write to the Sweat Chiropractic
Clinic, 3274 Buckeye Rd., N.E., Atlanta, GA 30341; or call (404) 457-4430.
References
- Palmer School of Chiropractic 1991 Announcement,
Davenport, Iowa: Palmer School of Chiropractic, 1911. p. 217.
- Palmer School of Chiropractic, 1947.
- Grostic, John F., Grostic Seminars, Ann Arbor, Mich.,
1946.
- American Medical Association, Guides to the Evaluation of
Permanent Impairment, 2nd Ed., p. 47.
- Sweat, R.W., Atlas Orthogonal Seminars, Atlanta, Ga.,
1980.
- Sweat, R.W., Atlas Orthogonal Seminars, Basic IV,
Atlanta, Ga., 1980.
- OUM, Olympic Underwriting Managers Group, Bellevue, Wash.
Standard of Care for Atlas Orthogonal Chiropractic Procedures
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