New Research on Importance of X-Rays in Chiropractic

Recent research reported in the Annals of Vertebral Subluxation Research on the accuracy of visual analysis versus x-ray analysis in patients with pelvic misalignments demonstrates that what chiropractors think they see on visualization for abnormal structural shifts in the pelvis does not match what is actually happening based on the x-rays.

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“Research is continuing to reveal the importance of radiography in chiropractic to determine structural shifts in spinal alignment” stated Dr. Matthew McCoy a chiropractor, public health researcher and editor of the journal that published the study. “Insurance companies and trade organizations like the American Chiropractic Association (ACA) have adopted unscientific policies that limit the use of x-rays by chiropractors and this research further establishes how wrong they are” added McCoy. 

The purpose of this study, conducted at Sherman College of Chiropractic in Spartanburg SC, was to compare radiographic and visual analysis methods for determining pelvic misalignments in patients.  Abnormal position or movement of the spinal vertebra can develop and this can lead to nerve interference. It is this interference, called vertebral subluxations, that chiropractors correct. 

According to researchers the nervous system controls and coordinates all functions of the body and structural shifts in the spine can occur that obstruct the nerves and interfere with their function. By removing the structural shifts, chiropractic improves nerve supply and function. 

Visualization is one of the components used by chiropractors to evaluate the structural shifts associated with subluxation and allow for the most appropriate application of the adjustment to reduce and/or remove the subluxation.  Foot flare, gluteal widths, and gluteal folds are some of the methods used in the visual assessment to determine pelvic misalignments. 

In the study, researchers first visually assessed for pelvic misalignment and then lumbopelvic x-rays were taken and evaluated using x-ray mensuration line analysis as per the Gonstead system.   Two Gonstead experienced chiropractors evaluated the x-rays and were blinded to the findings of the visual assessment.  

Agreement between both examiners performing line analysis was high in all categories and reached 100% agreement in many cases.  When visual analysis was used, there was as little as 38% agreement and at best it was only 41% agreement. “Overall this study shows that there is poor agreement between just eyeballing pelvic misalignments and actually measuring them” stated McCoy. He added “The results of this study are another nail in the coffin of the outdated methods promoted by those like the ACA that want to keep chiropractic in the dark ages. Restricting the use of x-rays in chiropractic is a public health threat given the importance of specific analysis and correction of vertebral subluxation.” 

The study’s authors called for additional research to investigate the clinical implications of objective measurement of structural spinal shifts.