The question of safety can be answered in several ways. Firstly, by examining and evaluating the strength of the anatomical structure of a child's spine; secondly, by reviewing the statistics pertaining to pediatric malpractice insurance claims.
Anatomy of the Pediatric Spine
The spine of a child is somewhat different from the fully developed spine of an adult. The vertebrae of a child's spine have abundant cartilage present, which eventually converts to bone, i.e., ossifies, as the spine continues to develop. The strength of a child's spinal vertebrae is derived, to a significant degree, from the elasticity of this cartilaginous tissue. Imagine trying to bend and distort a piece of cartilage, say that from the breast bone of a chicken. That is the type of material which comprises a significant percentage of each vertebral structure in the pediatric spine. Ossification of these cartilaginous sections continues at least until the middle of the second decade of life.
The young spine also has a high degree of ligament laxity which permits a greater degree of motion of individual vertebral structures. It is this ligament laxity which makes adjustment of a child's spine possible with very little pressure. A child's spinal vertebrae therefore can be adjusted without placing the structures under any significant stress which might be likely to cause harm. Another characteristic feature of the pediatric spine is that the popping sound, heard when adjusting the adult spine, will be heard less frequently in children. This is likely due to a combination of immature developing joint surfaces and the increased joint range of motion encountered in the developing spine.
After considering the anatomy of a child's spine and its associated structures, it is easy to see why the pediatric spine can tolerate the light forces used to make the necessary corrections without suffering any ill effects.
Children's spinal adjusting techniques are designed to further protect the developing spinal structures. Pediatric spinal adjusting techniques require the use of gentle, specific contacts with a light impulse through the doctor's finger-tip. Because of the flexibility of the developing spine and the size of a child's spinal joints, any adjustive thrust is kept to a minimum.
When a patient presents to a doctor for treatment and suffers in some way from a negligent act by that doctor, a malpractice suit usually follows. At least that is usually the case in the US. When one evaluates the statistics relating to malpractice claims, it is possible to determine if a particular practice or procedure is to be considered a risky one.
Using the same criteria to evaluate the safety of spinal adjustments for children indicates that the risk of children being injured as a result of having their spines adjusted by a chiropractor is negligible. In fact, a recent survey of malpractice insurance carriers in the US failed to identify any cases of childhood spinal injury caused by chiropractors. A great record, and a statistic which attests not only to the quality of care being provided but which also speaks to the quality of our pediatric chiropractic education programs.
You do, of course, occasionally hear sensational claims in the media that chiropractors have been implicated and are to be blamed in one case or another. In the last two years, the US media has published and televised several such claims involving children, but not one has proven to be true. Careful investigation, of each of these claims, has failed to produce any evidence of negligence or injury in any case in which a chiropractor was involved.
Why then are these claims made? Perhaps the kindest explanation is one of the need for television program ratings. Another, probably a little more accurate, might be a desperate attempt to dissuade parents from seeking chiropractic care for their children as a way of preserving market share for other sectors of the health care profession.
Whichever way parents react, the facts are inescapable:
Peter Fysh, DC
San Jose, CA
Editor's note: Dr. Fysh is currently conducting pediatric seminars. He may be contacted at: (408) 944-6000.
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