Lateral Full Spine Standing Radiographs

(From the November 2009 issue of “The Scope”)

Lateral Full Spine Standing Radiographs and Their Use in Biomechanical and Medical Studies

By: Steven T. Tanaka, DC.

A few researchers have been studying the sagittal or lateral view of the spine. Their primary interest is to find normal values for the alignment, curves, and vertebral positions and to see what alterations may be associated with spinal disorders in weight-bearing. The tool for all of the research papers quoted below is the 14” x 36” (30 cm x 90 cm) plain x-ray film. The studies are done standing or weight-bearing in order to observe posture, i.e., position of the pelvic structures and vertebrae , angulations, such as, the sacral base angle, and curves of the spine. They also understand that weight-bearing is necessary for accurate real-life measurements. Subsets of this area of research are to measure spinal curves and angulations and vertebral positions that are found in disorders, such as, spondylolisthesis, as well as, with aging and back pain. One of the goals of all of these studies is to understand the importance of restoring spinal sagittal curves after spinal instrumentation surgery, something that was not considered a few years ago. As the chiropractors understood years ago and many MDs dismissed, the sagittal curves are important in spinal health. One must look at how all of the regions of the spine are influenced by other regions, and in particular, by the pelvis.

In a nutshell, these researchers are taking these films for the same reasons we use them. They are looking at full spine, standing radiographs as an aid in determining prognosis based upon measurements of spinal alignment, angles, and curves. Measurements are taken of the sacrum and pelvis as they affect the spine above — sounds like the Gonstead Foundation concept. Much of the measurements are done digitally. Think of all of the MDs, and DCs, who have denied that spinal alignment is a factor in health and disease and that full spine, weight-bearing x-rays are not diagnostic. Research is starting to bear fruit and show the wisdom of chiropractic analysis of weightbearing, full spine x-rays in spinal health and dysfunction.

Many thanks to the GCSS Director of Research, Dr. Roger Coleman, for bringing this documented use of full spine radiography to our attention.