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Scoliosis x-rays

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The x-rays that are taken by ScoliSmart doctors expose the patient to significantly less radiation than a standard full spine film. According to the American Nuclear Society (www.ans.org), the average person is exposed to roughly 300 mR of naturally-occurring radiation every year.

The seven "spot" views of the spine that are taken by a ScoliSmart doctor totals 295 mR. By comparison, a single full spine film exposes the patient to 300 to 400 mR of radiation. The reason that a full spine film is so much greater is because the strength of the x-ray beam must be turned up to adequately penetrate all of the patient's tissues. In addition, the phenomenon of "scatter" causes x-ray penetrance to decrease as the film size becomes larger; this is why a small "spot" view is significantly less dangerous. X-rays in truth are one of the least dangerous diagnostic procedures used in medicine today, but suffer the greatest concerns about exposure; CT scans (of which over 70 million were performed in 2007 alone) expose the patient to 8,000 to 31,000 mR of radiation.

In addition to the amount of exposure, it's also important to consider the clinical value of the x-ray. If an x-ray is taken simply to "monitor" a scoliosis, and no clinical information regarding the patient's treatment can be derived from that x-ray, was it really worth it? The progression of a patient's scoliosis can be tracked in many different ways, such as MRI or surface topography. X-rays as a system for monitoring the progression of scoliosis seem anachronistic and outdated at best, downright irresponsible at worst. ScoliSmart doctors utilize a device called a Scoliometer to periodically evaluate the progression of a patient's scoliosis - only if it appears to be worsening as measured by the Scoliometer are additional x-rays taken.

The seven spot views taken by a ScoliSmart doctor are designed to provide the doctor with specific information about the biomechanical factors that are influencing the scoliosis in that specific patient's case. Every scoliosis is unique - it's impossible to design a "one-size-fits-all" exercise program that will work for every patient, or develop one "magic" chiropractic adjustment that corrects every patient's posture. Only through objective precision x-ray analysis can the exact biomechanical factors involved in a specific case of scoliosis be identified. Then, everything - the exercises, the adjustments, the therapies - are designed around that patient's specific spinal configuration. The information in these x-rays gives us the knowledge we need to make effective clinical decisions that will give the patient the best possible results. Clearly, the clinical value of these seven x-rays is much greater than a single full spine which is taken only to monitor progression.

Today's x-ray machines are a thousand times safer than the devices used in the past, for which a documented increased risk is published. Recent studies conducted on post-1980 devices find only a minimal risk, compared to pre-1970's, which found a significant risk.80,81 The x-ray technologies in use in the 21st century are even safer. According to the most current scientific literature, the risks of living with scoliosis are significantly worse than the risks of radiation exposure.

References:

80. Bone et al: The risk of carcinogenesis from radiographs for pediatric orthopedic patients. J Pediatric Orthop. 2000;20(2):251-254.

81. Doody et al: Breast cancer mortality rates after diagnostic radiography—Findings from the U.S. Scoliosis Cohort Study.  Spine 2000;25:2052-2063.

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