CJA Vol.22 Issue 4Utilisation of chiropractic services by members of
one private health fund in Victoria, 1990. Complications from manipulation of the low
back. Diagnostic imaging of the spine in chiropractic
practice: recommendations for utilisation. The role of plain film radiography in chiropractic
clinical practice. ABSTRACTS Utilisation of chiropractic services by members of one private health fund in Victoria, 1990. Ebrall PS A United States community-based study of the use of chiropractic services identified a substantial tail to the right. This Australian study explored data relative to 252,193 payments for chiropractic services made during 1990 by a major private health fund in Victoria, and found a similar substantial tail to the right, namely some 14.9% of all initial services were generated by 1.9% of practice locations, and some 14.7% of all subsequent visits were generated by 2.2% of practice locations. Utilisation was determined from the index of number of services per eligible member. Within the context of utilisation by the members of this particular private health insurer, the typical chiropractic practice location in Victoria accepted between 7 and 10 initial consultation services and generated between 168 and 243 subsequent services in 1990. Regions identified as demonstrating more than marginal atypical utilisation based on both absolute data and the index were (i) Central Gippsland, (ii) Central Highlands, (iii) South Western and (iv), The Wimmera. An attempt is made to identify factors which may contribute to atypical utilisation. Chiropractic J Aust 1992 Dec;22(4):122-8 Complications from manipulation of the low back. Terrett AG ; Kleynhans AM Practitioners of spinal manipulation should ensure that their therapy is as safe as possible for patients. Past attention to complications from manipulation centred mainly on the more serious vascular accidents of the cervical spine. The less life-threatening complications from manipulation of the lumbar spine have been largely overlooked. This descriptive analysis of such cases reported in the literature provides a basis for the development of diagnostic and therapeutic approaches designed to minimise complications. Chiropractic J Aust 1992 Dec;22(4):129-40 Diagnostic imaging of the spine in chiropractic practice: recommendations for utilisation. Schultz G ; Phillips RB ; Cooley J ; Hall T ; Hoyt T ; Gendreau D ; Knudsen JT ; Mitchel R ; Taylor JA Diagnostic imaging, especially plain film radiographs, continues to be a mainstay in the assessment of chiropractic patients. Unfortunately, the lack of agreement between clinicians and even academicians on what constitutes proper utilisation of x-rays continues to plague the profession. This document will attempt to assert some reasonable boundaries on the proper utilisation of diagnostic imaging in the assessment of chiropractic patients, and will contain a panoramic overview of all the imaging modalities likely to be ordered by a chiropractor. Modalities which might be frequently ordered by sub-specialists in the field of imaging will not be discussed, mainly because their acquisition will not be the result of initial assessments rendered by the doctor of chiropractic. Chiropractic J Aust 1992 Dec;22(4):141-52 The role of plain film radiography in chiropractic clinical practice. Plaugher G Since their sumultaneous discoveries in 1895, the disciplines of chiropractic and roentgenology have been linked in many of their applications and technological advancements. The integral component of x-ray analysis in clinical practice is important for a variety of reasons. Should bone weakening diseases be present, then the applied forces of an adjustment/manipulation could potentially cause harm to the patient. Plain film radiography has been used to rule out (to the extent possible) these pathologic processes. Chiropractors have adapted other approaches to x-ray diagnosis which are meant to supplement the analysis of bone and joint integrity, in order to provide information which is directly applicable to the administration of the primary modality used in practice, the adjustment. Biomechanical information can be gleaned from plain film radiographs. This information can then be used to evaluate different kinesiologic components of the subluxation complex such as positional or movement abnormalities. Practice guidelines suggested for chiropractic utilisation of x-ray should be different from those of a medical practitioner who does not use manipulation as a treatment. Chiropractic J Aust 1992 Dec;22(4):153-61 |
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