Vertebral subluxation represents the heart and soul of chiropractic, yet to many chiropractors, it remains a clinical conundrum. I believe that the controversy and confusion surrounding the chiropractic concept of vertebral subluxation is due, in part, to the lack of an operational definition compatible with most techniques.
A review of models of vertebral subluxation has been published elsewhere.1 However, regardless of the elegance of a theoretical model, it must be capable of being operationalized if it is to be used to develop clinical strategies. The four-dimensional model was developed as an initial step in the operational definition of vertebral subluxation. It incorporates traditional chiropractic constructs and serves as a bridge to contemporary technology.