Cervical Film Analysis

When normal function returns, the neurologic and other components of the Subluxation complex resolve by the normal healing power referred to historically as “innate intelligence”. Once structural abnormalities, pathologies, and positional errors are addressed, chiropractic analysis begins as below. We utilize 8 X 10 films for the stress (flexion, extension and rotation) views.

The A-P View The spine should be straight and all spino-laminar junctions should be midline. There should be no lateral tilt to the head.

The Open Mouth View

Teeth must not overlay the occipital condyles for the “classic” upper cervical Palmer analysis of C1 and C2 for laterality. You will note that the posterior arch of C1 overlies the lateral masses (LM) of C1. A triangular portion of each LM will be observed below the posterior arch. Increased size of one of these triangles would suggest posterior rotation of Atlas in that side.

Neutral Lateral Film Analysis

The normal cervical lordosis (from C1 to T2) should have a 17-24-cm. radius, based on patient height. The lordotic cervical & lumbar spines are the basis of the spine’s ability to resist axial pressures. Thus, a reduced cervical curve can result in a 50% reduction in the strength of the spine!

Flexion Film Analysis

When the spine flexes, it should fully reverse the curve. Three things should also happen in flexion. The zygapophyses should slide upwards and forwards. For this reason, the IVF’s should open fully. And lastly, the spinous processes should “fan out” or separate. Occiput should notate forwards, and the C1 posterior arch will tend to approximate the back of occiput.

A segment, which has lost the ability to flex, would be labeled a “flexion lock”. Please note that in flexion (as in the neutral view), George’s posterior bodyline should still be a curved line with all segments on one line. If you require more than one line to connect all the segments, the subluxated segment will reside in the portion of the spine, which is straightened. In flexion lock, often the segment just below the intersection of the 2 straight George’s lines is the subluxated segment. The most obvious indicator would be that segment which fails to flex and thus, increase the size of its IVF.

Extension Film Analysis

As with flexion, 3 things occur. The facets should move backwards and down, the IVF’s close down, and all the spinous processes should approximate.Again, all segments should remain on one curved line. A segment, which will not extend is described as being “locked in extension”.

Rotational Film Analysis
When the head rotates or laterally bends, lateral bending and rotation must occur simultaneously. This is referred to as “coupled motion” and is well described in White & Punjabi’s “Clinical Biomechanics of the Spine”. In the cervical spine, the spinous processes must move opposite to the motion of the face. If you look to the right, the spinous processes must move to the left.