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. 2015 Jun;59(2):173-92.

Craniocervical chiropractic procedures - a précis of upper cervical chiropractic

H Charles Woodfield 3rd  1 , Craig York  2 , Roderic P Rochester  3 , Scott Bales  4 , Mychal Beebe  5 , Bryan Salminen  6 , Jeffrey N Scholten  7
Affiliations

Craniocervical chiropractic procedures - a précis of upper cervical chiropractic

H Charles Woodfield 3rd et al. J Can Chiropr Assoc. 2015 Jun.

Abstract
in English, French

Presented here is a narrative review of upper cervical procedures intended to facilitate understanding and to increase knowledge of upper cervical chiropractic care. Safety, efficacy, common misconceptions, and research are discussed, allowing practitioners, chiropractic students, and the general public to make informed decisions regarding utilization and referrals for this distinctive type of chiropractic care. Upper cervical techniques share the same theoretical paradigm in that the primary subluxation exists in the upper cervical spine. These procedures use similar assessments to determine if spinal intervention is necessary and successful once delivered. The major difference involves their use of either an articular or orthogonal radiograph analysis model when determining the presence of a misalignment. Adverse events following an upper cervical adjustment consist of mild symptomatic reactions of short-duration (< 24-hours). Due to a lack of quality and indexed references, information contained herein is limited by the significance of literature cited, which included non-indexed and/or non-peer reviewed sources.

Examen narratif de procédures de la cervicale supérieure afin de faciliter la compréhension et d’améliorer la connaissance des soins chiropratiques des cervicales supérieures. L’innocuité, l’efficacité, les méconnaissances courantes et la recherche font l’objet de discussion, ce qui permet aux praticiens, aux étudiants en chiropratique, et au public de prendre des décisions éclairées concernant l’utilisation et les recommandations pour ce type particulier de soins chiropratiques.Les techniques de la cervicale supérieure ont le même paradigme théorique, car les subluxations primaires existent dans la colonne cervicale supérieure. Ces procédures ont recours à des évaluations semblables pour déterminer si une intervention vertébrale est nécessaire et si elle est réussie une fois effectuée. La différence principale concerne l’utilisation soit d’une analyse radiographique articulaire ou orthogonale au moment de déterminer la présence d’un désalignement. Des évènements indésirables à la suite d’un ajustement de la cervicale supérieure consistent en des réactions symptomatiques légères de courte durée (< 24 heures).Étant donné le manque de références indexées et de qualité, les renseignements contenus aux présentes sont limités par l’importance des documents cités, qui comprennent des sources non indexées ou non révisées par des pairs.

Keywords: adverse events; atlas; cervical; chiropractic; chiropractic adjustment; craniocervical.

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Figures

Figure 1.
Figure 1.
Supine Leg Check (SLC) The supine leg check test looks for apparent functional leg length inequality indicating need for further patient evaluation. Leg length appears ‘even’ in this example.
Figure 2.
Figure 2.
Thermographic Scan (Thermogram) from Tytron C-5000 (Titronics, Tiffin, IA 52340) Used by the Knee Chest and some Blair groups. 2a. Thermogram indicates adjustment needed 2b. Thermogram is ‘clear’ indicating no adjustment needed.
Figure 3.
Figure 3.
The Anatometer The Anatometer measures postural asymmetry and was designed to decrease the number of radiographs required in patient care.
Figure 4.
Figure 4.
The Gravity Stress Analyzer (GSA) 4a. The GSA is used by many Canadian NUCCA Practitioners 4b. GSA Shoulder calipers 4c. GSA Hip Calipers
Figure 5.
Figure 5.
Orthogonal Analysis Model Film Series 5a. Lateral 5b. Nasium 5c. Vertex These films are used to determine atlas misalignment, develop a correction strategy and ensure an appropriate correction has been made.
Figure 6.
Figure 6.
Articular Analysis Model Film Series 6a. Lateral Cervical 6b. Base Posterior (BP) 6c. Anterior-Posterior Open Mouth (APOM) The lateral cervical view is used to determine atlas anteriority, if the atlas is anterior or posterior under the occipital condyles and if the axis (C2) is posterior and/or inferior. The BP is used primarily to determine any rotation of the atlas on the condyles. The APOM view reveals atlas laterality and the pivots of axis.
Figure 7:
Figure 7:
Blair Protractoview showing condyle underlap/overlap (see white arrows) 7a. Protractoview C-1 Overlap (left) 7b. Protractoview C-1 Underlap (left) 7c. Protractoview C-1 Juxtaposed (right)
Figure 8.
Figure 8.
Orthospinology Hand-held Instrument Adjustment
Figure 9.
Figure 9.
Orthospinology Table Instrument Adjustment
Figure 10.
Figure 10.
NUCCA Correction using the “triceps pull.”
Figure 11.
Figure 11.
Knee Chest Adjustment
Figure 12.
Figure 12.
Blair adjustment
See this image and copyright information in PMC

References

    1. Hynes RJR, Callender AK. Technique in the classroom at Palmer College of Chiropractic: A History in the Art of Chiropractic. J Chiropr Humanit. 2008;(15):55–66.
    1. Young KJ. Evaluation of publicly available documents to trace chiropractic technique systems that advocate radiography for subluxation analysis: a proposed genealogy. J Chiropr Humanit. 2014;21(1):1–24. - PMC - PubMed
    1. Christensen MG. Job Analysis of Chiropractic A Project Report, Survey Analysis and Summary of the Practice of Chiropractic within the United States. Greeley, Colorado: National Board of Chiropractic Examiners; 2000.
    1. Palmer BJ. The subluxation specific – the adjustment specific. Davenport: Palmer School of Chiropractic; 1934.
    1. Wernsing AA. The atlas specific. Hollywood: Oxford Press; 1941.

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