Braden Keil BAppSc(Chiropractic), MChiroSc (Paediatrics), FICC, a self proclaimed chiropractic pediatric expert provided testimony against another chiropractor to the Chiropractic Board of Australia alleging that pediatric spine normals do not exist. Dr. Keil was responding to cross examination during his testimony.
Keil was asked during cross examination: ". . . if a practice includes the correction of structure and one of the criteria is evaluation of spinal curvature progression that would also mean improvement as one of the indicators?"
Dr. Keil responded:
"The problem is that because the normal spine curvatures haven't been defined in the paediatric age ranges you can't use them clinically as a measure of treatment outcome or the presence of an abnormality. So until the norms are defined you can't say that this situation on this individuals x-ray is abnormal and needs treatment or that treatment has improved and moved the patients curvature more to normal because we don't know what normal is."
When Dr. Keil was asked who he was referring to when he said "we don't know . . " he responded:
"The chiropractic community, the medical community. I've been unable to find any literature published relating to normal spine curve angles for paediatric age ranges."
Its quite shocking that Dr. Keil, who holds himself out to be a pediatric expert, is unaware of what anyone with access to Google could find regarding pediatric spinal norms. But what is even more shocking is that apparently no one on the Chiropractic Board of Australia knows that such pediatric spine normals do in fact exist and these are the people policing the rest of the profession. And they used Keil's testimony against the chiropractor.
This is also setting aside that Keil feels he represents the entire chiropractic and medical community.
On his website Dr. Keil states the following about his credentials:
"Dr Braden Keil graduated as a chiropractor in 1987 and then completed a Master degree in chiropractic paediatrics. Dr Keil is one of only a few chiropractors in Australia to have gained this qualification. Dr Keil practised for many years in Scotland and returned to Australia during 2000 to open Chiropractic Children's Healthcare and was awarded a Fellowship by the International College of Chiropractors (FICC) during 2001. Dr Keil is the author of the world's first full time Fellowship program in Chiropractic Paediatrics. From 2004 to 2008 Dr Keil lectured on paediatrics to students in the RMIT Chiropractic undergraduate program.Dr Keil developed and wrote Australia's first 2 year post graduate Diplomate in Chiropractic Paediatrics program which is currently taught around Australia to chiropractors wanting to learn how to better help their paediatric patients."
The subject of x-rays in chiropractic has been in the news recently as The Australian Government targeted chiropractors with changes to their Medicare Benefits Schedule (MBS) in regards to spinal x-rays and who can request them. The changes came about from a review by the MBS Review Task Force and are effective beginning November 1, 2017.
Beyond the ridiculous reliance on an either ignorant expert witness at best or intentional deceptive testimony, the facts are that numerous chiropractic guidelines and best practices documents exist that support imaging in both pediatric and adult populations.
Radiographs are routinely utilized and necessary in the analysis and correction of vertebral subluxation. This has been supported by several chiropractic practice guidelines documents for over nearly two decades.
The argument has been that since only one in about 2500 people will have a pathology show up on x-ray that chiropractors should attempt a brief course of care prior to taking x-rays. Of course that argument puts the public at risk since chiropractors put forces into the spine and should there be a pathology present could lead to devastating consequences.
Chiropractors in all jurisdictions are encouraged to speak out against activist chiropractors who wield their power and enforce their chiropractic worldview by testifying against other chiropractors and then give false, misleading or inaccurate statements. Regulatory boards who rely on these chiropractors as witnesses should also be held accountable.
The following is a just a short list of the available evidence that directly refutes Dr. Keil's testimony.
Kasai T, Ikata T, Katoh S, et al. Growth of the cervical spine with special reference to its lordosis and mobility. Spine 1996; 21(18):2067-2073.
Hasan G, Hamid H, Ameri E, and Noori A. “Assessment of Normal Sagittal Alignment of the Spine and Pelvis in Children and Adolescents,” BioMed Research International, vol. 2013, Article ID 842624, 7 pages, 2013. doi:10.1155/2013/842624
Mac-Thiong, Jean-Marc, Berthonnaud, Éric Dimar, John R. II. Betz, R, Labelle H. Sagittal Alignment of the Spine and Pelvis During Growth. Spine: 1 August 2004 - Volume 29 - Issue 15
E. H. Boseker, J. H. Moe, R. B. Winter, and S. E. Koop, “Determination of “normal” thoracic kyphosis: a roentgenographic study of 121 “normal” children,” Journal of Pediatric Orthopaedics, vol. 20, no. 6, pp. 796–798, 2000.
J.-M. Mac-Thiong, H. Labelle, E. Berthonnaud, R. R. Betz, and P. Roussouly, “Sagittal spinopelvic balance in normal children and adolescents,” European Spine Journal, vol. 16, no. 2, pp. 227–234, 2007.
S. L. Propst Proctor and E. E. Bleck, “Radiographic determination of lordosis and kyphosis in normal and scoliotic children,” Journal of Pediatric Orthopaedics, vol. 3, no. 3, pp. 344–346, 1983.
