Wednesday, October 7, 2009

Upper Cervical Corrections by Hand or Instrument?

I think this is a fair assessment of the question above.

Cecil D. Laney, D.C.

Chiropractic is a philosophy, science and art. The philosophy is our core beliefs which maintain that optimum nerve function is vital to good health and that the nerve function can have interference and this interference can be removed.

The science is the mathematical determination of the structural integrity of the human body. It also addresses the postural standards as to what is normal and optimum to achieve normal nerve function.

The art is the skill with which we render service to the patient in restoring nerve function in the pursuit of better health.

Without data, everything is just an opinion. Therefore, I will offer opinions after over 50 years of observation. I am saying that our greatest failure has been our poor achievement in the art of chiropractic.

Someone estimated that there are over 150 different techniques in the country. I think that there are really two major procedures, the manipulators and the specific adjusters. There is a difference. To manipulate, you move structure randomly. To adjust, you move structure from a given place to a different given place. Unfortunately, the vast majority of chiropractic practices consists of manipulation.

The time is here when the powers that be, the government, insurance companies, etc. are asking: "What do you chiropractors do?" Our answer is: "We correct spinal distortions." But do we? Can you prove it? Do you take pre and post x-rays? If not, what is your method of evaluation?

Dr. B.J. Palmer said the subluxation can only exist in the cervical area. My experience leads me to agree with him. In this area, palpation and postural observation are helpful, but the only reliable performance monitoring method is precision pre and post x-rays. This is the only method I accept.

I have heard claims of everything up to 100% on nearly all cases. I have yet to see proof of this kind of performance. Dr. John D. Grostic told me his father had about 87% overall average correction. This was a surprise to me in view of the fact that adjusting me, he hit 100% almost every time.

It doesn't tell us much if you show a case of 100% correction, but it will give a picture of your performance if you show a dozen consecutive cases with close proximity dates on the film.

In discussions with some of our best hand adjusters, I have come to the conclusion that their overall average is in the nature of 50%. This is good, a far better performance than the manipulators. It is about twice as good as I was ever able to do. I applaud anyone who is training themselves to hand adjust. Maybe someone will come up with a modification of the procedure that will make it more doable.

My observation is that an average 50% correction will eventually build a referral practice even if the doctor has a sour disposition. A 70% average correction will build you an overflow practice.

We are entering a new era in the art of chiropractic. I have designed, built and delivered to Life University a new table mounted cervical adjusting instrument, giving them all rights to it. It has functions that to my knowledge, has never been utilized before. It is being evaluated in the Research Department. We expect to achieve 80 to 90 percent average corrections. This kind of performance will make miracle cases commonplace. The instrument uses the Grostic analysis and adjusting vectors. We urgently need for it to be placed in a few Grostic proficient doctors' offices to accumulate data.

If my opinion is wrong and you can document a correction performance of 70% or above, I want to be a student of yours. If you are averaging much less than 50% with hand adjusting, I would recommend you move to the use of adjusting instruments. It is not fair to your patients to do otherwise.

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