Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.1 A year later, I presented a series of brief cases demonstrating patient improvement in reverse digit span – an outcome measure related to attention span – under chiropractic care.2 This series included patients with and without concussion. In the process of preparing these articles, as well as organizing material for postgraduate courses, I naturally found myself reviewing much of the biomedical and chiropractic clinical literature relevant to concussion and the vertebral subluxation complex (as defined in Redwood, 1997).3 Let's try a few simple thought experiments and then discuss why a new classification term – the concussion-subluxation complex – may be warranted.
Two Thought Experiments
Try these two thought experiments (experiments conducted entirely within the confines of your own mind); I believe the results will speak for themselves.
- Thought Experiment #1: Imagine every possible injury that could cause a concussion. What percentage of these injuries left the vertebral column unharmed and unsubluxated?
- Thought Experiment #2: I invite you to examine the table. The clinical features of concussion are drawn from the Zurich Statement (McCrory, et al., 2012),4 the Centers for Disease Control and Prevention (CDC),5 Eckner, et al. (2011 and 2013),6-7 and Kontos, et al. (2013).8 I have left the column labeled "Vertebral Subluxation Complex" blank. Based on your personal clinical experience, and your understanding of the clinical literature and basic science, please fill in this column. How many times did you write "No"?
References
November 2015
Trending
Diagnosis & Diagnostic Equip
K. Jeffrey Miller, DC, MBA
Health & Wellness / Lifestyle
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
Manesh Girn, PhD;
Melanie Pincus, PhD
X-ray / Imaging / MRI
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
James Lehman, DC, MBA, DIANM
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