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(Digital Motion X-Ray: Non-fluoroscopic) Conventional radiography is now used for the recording of motion studies. This method does not employ the use of fluoroscopy that has been the most common use of X-rays but rather uses conventional X-rays. The manner of recording a motion study is to couple an X-ray system with a digital computer and a detection system that records images in real time.
Example: The A2D2, Inc. Model 1713 is a digital system that is capable of recording static images or a dynamic sequence.
Static images are recorded in a 5,000 by 4,000 pixel array with 14 bit capacity. These images are stored in the computer memory for recording and/or playback. Dynamic studies are recorded in real time at a rate of 30 frames per second with resolution of 1990 by 1200 pixels. Typically, one second of data recording is required for a complete motion study at 30 frames per second. Sophisticated software is used to automatically record the study and then to cause it to playback in a bi-directional format.
Patient radiation dose is minimal over the one second time frame. Typical radiation dose is approximately 2 mSv for this one second period. Any form of joint motion can be recorded and analyzed.
Related Research Articles
Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It has esoteric origins and is based on several pseudoscientific ideas.
A subluxation is an incomplete or partial dislocation of a joint or organ. According to the World Health Organization, a subluxation is a "significant structural displacement" and is therefore visible on static imaging studies, such as X-rays. Unlike real subluxations, the pseudoscientific concept of a chiropractic "vertebral subluxation" may or may not be visible on x-rays.
Whiplash is a non-clinical term describing a range of injuries to the neck caused by or related to a sudden distortion of the neck associated with extension, although the exact injury mechanisms remain unknown. The term "whiplash" is a colloquialism. "Cervical acceleration–deceleration" (CAD) describes the mechanism of the injury, while the term "whiplash associated disorders" (WAD) describes the subsequent injuries and symptoms.
Spondylosis is the degeneration of the vertebral column from any cause. In the more narrow sense it refers to spinal osteoarthritis, the age-related degeneration of the spinal column, which is the most common cause of spondylosis. The degenerative process in osteoarthritis chiefly affects the vertebral bodies, the neural foramina and the facet joints. If severe, it may cause pressure on the spinal cord or nerve roots with subsequent sensory or motor disturbances, such as pain, paresthesia, imbalance, and muscle weakness in the limbs.
Degenerative disc disease (DDD) is a medical condition typically brought on by the normal aging process in which there are anatomic changes and possibly a loss of function of one or more intervertebral discs of the spine. DDD can take place with or without symptoms, but is typically identified once symptoms arise. The root cause is thought to be loss of soluble proteins within the fluid contained in the disc with resultant reduction of the oncotic pressure, which in turn causes loss of fluid volume. Normal downward forces cause the affected disc to lose height, and the distance between vertebrae is reduced. The anulus fibrosus, the tough outer layers of a disc, also weakens. This loss of height causes laxity of the longitudinal ligaments, which may allow anterior, posterior, or lateral shifting of the vertebral bodies, causing facet joint malalignment and arthritis; scoliosis; cervical hyperlordosis; thoracic hyperkyphosis; lumbar hyperlordosis; narrowing of the space available for the spinal tract within the vertebra ; or narrowing of the space through which a spinal nerve exits with resultant inflammation and impingement of a spinal nerve, causing a radiculopathy.
A retrolisthesis is a posterior displacement of one vertebral body with respect to the subjacent vertebra to a degree less than a luxation (dislocation). Retrolistheses are most easily diagnosed on lateral x-ray views of the spine. Views where care has been taken to expose for a true lateral view without any rotation offer the best diagnostic quality.
Spinal adjustment and chiropractic adjustment are terms used by chiropractors to describe their approaches to spinal manipulation, as well as some osteopaths, who use the term adjustment. Despite anecdotal success, there is no scientific evidence that spinal adjustment is effective against disease.
Spinal manipulation is an intervention performed on spinal articulations, synovial joints, which is asserted to be therapeutic. These articulations in the spine that are amenable to spinal manipulative therapy include the z-joints, the atlanto-occipital, atlanto-axial, lumbosacral, sacroiliac, costotransverse and costovertebral joints. National guidelines come to different conclusions with respect to spinal manipulation with some not recommending it, and others recommending a short course in those who do not improve with other treatments.
Congenital vertebral anomalies are a collection of malformations of the spine. Most, around 85%, are not clinically significant, but they can cause compression of the spinal cord by deforming the vertebral canal or causing instability. This condition occurs in the womb. Congenital vertebral anomalies include alterations of the shape and number of vertebrae.
Vertebral artery dissection (VAD) is a flap-like tear of the inner lining of the vertebral artery, which is located in the neck and supplies blood to the brain. After the tear, blood enters the arterial wall and forms a blood clot, thickening the artery wall and often impeding blood flow. The symptoms of vertebral artery dissection include head and neck pain and intermittent or permanent stroke symptoms such as difficulty speaking, impaired coordination, and visual loss. It is usually diagnosed with a contrast-enhanced CT or MRI scan.
A spinal disc herniation is an injury to the intervertebral disc between two spinal vertebrae, usually caused by excessive strain or trauma to the spine. It may result in back pain, pain or sensation in different parts of the body, and physical disability. The most conclusive diagnostic tool for disc herniation is MRI, and treatment may range from painkillers to surgery. Protection from disc herniation is best provided by core strength and an awareness of body mechanics including good posture.
Joint manipulation is a type of passive movement of a skeletal joint. It is usually aimed at one or more 'target' synovial joints with the aim of achieving a therapeutic effect.
Manipulation under anesthesia (MUA) or fibrosis release procedures is a multidisciplinary, chronic pain-related manual therapy modality which is used for the purpose of improving articular and soft tissue movement. This is accomplished by way of a combination of controlled joint mobilization/manipulation and myofascial release techniques. MUA is used by osteopathic/orthopedic physicians, chiropractors and specially trained physicians. It aims to break up adhesions on or around spinal joints or extremity joints to which a restricted range of motion can be painful and limit function. Failed attempts at other standard conservative treatment methods, over a sufficient time-frame, is one of the principal patient qualifiers.
Chiropractors use their version of spinal manipulation as their primary treatment method, with non-chiropractic use of spinal manipulation gaining more study and attention in mainstream medicine in the 1980s. There is no evidence that chiropractic spinal adjustments are effective for any medical condition, with the possible exception of treatment for lower back pain. The safety of manipulation, particularly on the cervical spine has been debated. Adverse results, including strokes and deaths, are rare.
Denticulate ligaments are lateral projections of the spinal pia mater forming triangular-shaped ligaments that anchor the spinal cord along its length to the dura mater on each side. There are usually 21 denticulate ligaments on each side, with the uppermost pair occurring just below the foramen magnum, and the lowest pair occurring between spinal nerve roots of T12 and L1. The denticulate ligaments are traditionally believed to provide stability for the spinal cord against motion within the vertebral column.
The term sacroiliac joint dysfunction refers to abnormal motion in the sacroiliac joint, either too much motion or too little motion, that causes pain in this region.
Passive accessory intervertebral movements (PAIVM) refers to a spinal physical therapy assessment and treatment technique developed by Geoff Maitland. The purpose of PAIVM is to assess the amount and quality of movement at various intervertebral levels, and to treat pain and stiffness of the cervical and lumbar spine.
Forward head posture (FHP) is an excessively kyphotic (hunched) thoracic spine. It is clinically recognized as a form of repetitive strain injury. The posture can occur in dentists, surgeons, and hairdressers, or people who spend time on electronic devices. It is one of the most common postural issues. There is a correlation between forward head posture and neck pain in adults, but not adolescents.
Craniocervical instability (CCI) is a medical condition characterized by excessive movement of the vertebra at the atlanto-occipital joint and the atlanto-axial joint located between the skull and the top two vertebra, known as C1 and C2. The condition can cause neural injury and compression of nearby structures, including the brain stem, spinal cord, vagus nerve, and vertebral artery, resulting in a constellation of symptoms.
Nikolai Bogduk is a retired Australian anatomist, and emeritus professor of the University of Newcastle Bone & Joint Institute, Australia. His research and publications were primarily on the anatomical sources and causes of chronic spinal pain and headache, as well as the development of new diagnostic techniques and treatments for these conditions. He has made significant contributions to the field of spinal anatomy, biomechanics, as well as spinal pain diagnosis and management.
References
(Motion X-Ray)
1. Bill O'Neill inventor of and leader in non-fluoroscopic digital motion x-ray technology.
(DMX)
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