The Scoliosis Quandary: Are Radiation Exposures From Repeated X-Rays Harmful?

Oakley, Paul A.; Ehsani, Niousha Navid; Harrison, Deed E.

doi:10.1177/1559325819852810

Cited by 45 publications

(68 citation statements)

References 69 publications

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“…Concerns over radiation exposures during routine spinal X-ray imaging need discussion. Although this topic has been thoroughly discussed elsewhere [57][58][59][60], in brief, patient exposures from spinal X-rays are not harmful. First, the assumption that radiation exposures from low-doses are carcinogenic is false; low-doses of radiation (including X-rays and CT scans) stimulate the adaptive protection systems in the body to "over-repair" any genetic damage done, including DNA double strand breaks by imaging [61].…”

Section: Contraindications To Extension Tractionmentioning

confidence: 99%

“…First, the assumption that radiation exposures from low-doses are carcinogenic is false; low-doses of radiation (including X-rays and CT scans) stimulate the adaptive protection systems in the body to "over-repair" any genetic damage done, including DNA double strand breaks by imaging [61]. Second, because of point one, there is no cumulative effect; therefore, the only relative risk can be considered from a single session of X-rays (i.e., 1-3 mGy) [57,58]. Third, due to point two, the amount of radiation from X-rays of 1-3 mGy is many times lower than the recognized dose threshold for leukemia of 1100 mGy (95% CI: 500-2600 mGy) [57,62] and therefore cannot be carcinogenic.…”

Section: Contraindications To Extension Tractionmentioning

confidence: 99%

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Restoration of Cervical and Lumbar Lordosis: CBP® Methods Overview

Oakley¹,

Moustafa²,

Harrison³

2021

Spinal Deformities in Adolescents, Adults and Older Adults

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Low back and neck pain disorders are among the leading causes for work loss, suffering, and health care expenditures throughout the industrialized world. It has been extensively demonstrated that sagittal plane alignment of the cervical and lumbar spines impacts human health and well-being. Today there are reliable and predictable means through the application of extension spinal traction as part of comprehensive rehabilitation programs to restore the natural curvatures of the spine. High-quality evidence points to Chiropractic BioPhysics® (CBP®) methods offering superior long-term outcomes for treating patients with various craniocervical and lumbosacral disorders. CBP technique is a full spine and posture rehabilitation approach that incorporates mirror image® exercises, spinal and postural adjustments, and unique traction applications in the restoration of normal/ideal spinal alignment. Recent randomized controlled trials using CBP's unique extension traction methods in conjunction with various conventional physiotherapeutic methods have demonstrated those who restore normal lordosis (cervical or lumbar) get symptomatic relief that lasts up to 2 years after treatment. Comparative groups receiving various 'cookie-cutter' conventional treatments experience only temporary symptomatic relief that regresses as early as 3 months after treatment. The economic impact/benefit of CBPs newer sagittal spine rehabilitation treatments demand continued attention from clinicians and researchers alike.systematically as the Harrison group [4][5][6][7][8][9][10][11]. Elliptical shape modeling of the path of the posterior longitudinal ligament along the posterior vertebral body margins was chosen due to the ease of clear identification of these spine landmark points and for the ability to easily make measurements of spine segmental and total angle of curvature on patient radiographs to compare patient measurements to model predictions. Modeling was performed on radiographic samples of asymptomatic participants. Computer iterations of spinal shape modeling was applied to determine best-fit geometric spine shapes by fitting various ellipses of altering minor-to-major axes ratios to digitized posterior vertebral body corners on samples of radiographs of the cervical [4-6], thoracic [7,8], and lumbar spinal regions [9][10][11] (Figure 3).The Harrison normal spinal model (Figure 3) features a circular cervical lordosis, and portions of an elliptical curve for both the thoracic kyphosis (more curvature cephalad), and lumbar lordosis (more curvature caudad). Consequently, features of the normal human spine reveal that the opposite thoracic and lumbar curves meet together at the thoraco-lumbar junction being essentially straight; the upper, deeper curve of the upper thoracic spine reflects oppositely at the cervico-thoracic junction (between T1 and T2) and continues into the cervical lordosis; the lower lumbar spine increases its lordotic alignment having two-thirds of its curve between L4-S1 as it meets the forward tilted sacral base. T...

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Section: Contraindications To Extension Tractionmentioning

confidence: 99%

Section: Contraindications To Extension Tractionmentioning

confidence: 99%

Restoration of Cervical and Lumbar Lordosis: CBP® Methods Overview

Oakley¹,

Moustafa²,

Harrison³

2021

Spinal Deformities in Adolescents, Adults and Older Adults

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show abstract

“…Thus, as Oakley et al have pointed out, scoliosis patients at most must be evaluated for harmful exposure from the total dose received from a single X-ray examination procedure, or about 1-3 mGy. 109 This makes the above aforementioned 0.25% increase above a 40% background cancer incidence all the more irrelevant (i.e. 0.005-0.015% added to background).…”

Section: Discussionmentioning

confidence: 99%

5 Reasons Why Scoliosis X-Rays Are Not Harmful

2020

Self Cite

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Radiographic imaging for scoliosis screening, diagnosis, treatment, and management is the gold standard assessment tool. Scoliosis patients receive many repeat radiographs, typically 10-25 and as many as 40-50, equating to a maximum 50 mGy of cumulative exposure. It is argued this amount of radiation exposure is not carcinogenic to scoliosis patients for 5 main reasons: 1. Estimated theoretical cumulative effective doses remain below the carcinogenic dose threshold; 2. Scoliosis patient x-rays are delivered in serial exposures and therefore, mitigate any potential cumulative effect; 3. Linear no-threshold cancer risk estimates from scoliosis patient cohorts are flawed due to faulty science; 4. Standardized incidence/mortality ratios demonstrating increased cancers from aged scoliosis cohorts are confounded by the effects of the disease entity itself making it impossible to claim cause and effect resulting from low-dose radiation exposures from spinal imaging; 5. Children are not more susceptible to radiation damage than adults. Radiophobia concerns from patients, parents, and doctors over repeat imaging for scoliosis treatment and management is not justified; it adds unnecessary anxiety to the patient (and their parents) and interferes with optimal medical management. X-rays taken in the evidence-based management of scoliosis should be taken without hesitation or concern about negligible radiation exposures.

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“…However, the multiple X-ray exposures during control visits would be too burdensome for the children. 17,18 On the other hand, the newest systems using e.g. convolutional neural networks were developed and proposed for clinical assessment.…”

Section: Spinalmeter Methods For the Determination Of Postural Status mentioning

confidence: 99%

The SpinalMeter biometrical assessment to improve posture diagnosis in school-age girls: a validation study

Kamelska-Sadowska

Protasiewicz-Fałdowska

Zaborowska-Sapeta

et al. 2020

Pol. Ann. Med.

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Introduction: Assessing spinal deformities using an X-ray radiation is the method of choice for posture diagnosis. It is also used for the evaluation of the degree of correction, brace fit, and spinal balance as well as for further management decisions. However, multiple X-ray exposures during control visits could be too burdensome for children. Aim: The aim of this study was to investigate the precision and repeatability of measurement of the variables obtained by a fast, simple postural evaluation in children by the SpinalMeter. Material and methods: The measurements of the angle of trunk rotation (ATR) and SpinalMeter posture assessments were performed 8 to 10 times in a short period of time (6 s). The overall of 300 photos (SpinalMeter) and 1020 measurements (asymmetry, distance between anthropometric points as well as ATR) were obtained from 6 girls (8–15 years old). The validation study comprised of the repeatability, interclass correlation coefficient (Qw) and relative standard deviation (rSD) measurements. Results and discussion: The measurements of the distance between acromion–popliteal fossa, acromion–iliac crest, and acromion–posterior superior iliac spine obtained by SpinalMeter were clearly repeatable (Qw > 0.9). The scapular and pelvic asymmetry in standing and sitting positions were highly repeatable and had low rSD (e.g. for scapular asymmetry 5.6%–80.3%; Qw > 0.8). Conclusions: The precise and reliable postural biometrical measurements were performed by SpinalMeter in the case of the distance between anthropometric points and asymmetry of pelvis and scapula. These measurements could be useful in the assessment of girl’s posture when visiting the pediatrician.

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The Scoliosis Quandary: Are Radiation Exposures From Repeated X-Rays Harmful?

Cited by 45 publications

References 69 publications

Restoration of Cervical and Lumbar Lordosis: CBP® Methods Overview

Restoration of Cervical and Lumbar Lordosis: CBP® Methods Overview

5 Reasons Why Scoliosis X-Rays Are Not Harmful

The SpinalMeter biometrical assessment to improve posture diagnosis in school-age girls: a validation study

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