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对辐射的恐惧、对医学参考文献的挪用以及对相关数据的忽视构成了反对在整脊疗法和手法治疗中使用常规和重复放射成像的错误立场。

Radiophobic Fear-Mongering, Misappropriation of Medical References and Dismissing Relevant Data Forms the False Stance for Advocating Against the Use of Routine and Repeat Radiography in Chiropractic and Manual Therapy.

作者信息

Oakley Paul A, Harrison Deed E

机构信息

Private Practice, Newmarket, Ontario, Canada.

Deed Harrison, CBP NonProfit, Inc, Eagle, ID, USA.

出版信息

Dose Response. 2021 Feb 11;19(1):1559325820984626. doi: 10.1177/1559325820984626. eCollection 2021 Jan-Mar.

Abstract

There is a faction within the chiropractic profession passionately advocating against the routine use of X-rays in the diagnosis, treatment and management of patients with spinal disorders (aka subluxation). These activists reiterate common false statements such as "there is no evidence" for biomechanical spine assessment by X-ray, "there are no guidelines" supporting routine imaging, and also promulgate the reiterating narrative that "X-rays are dangerous." These arguments come in the form of recycled allopathic "red flag only" medical guidelines for spine care, opinion pieces and consensus statements. Herein, we review these common arguments and present compelling data refuting such claims. It quickly becomes evident that these statements are false. They are based on cherry-picked medical references and, most importantly, expansive evidence against this narrative continues to be ignored. Factually, there is considerable evidential support for routine use of radiological imaging in chiropractic and manual therapies for 3 main purposes: 1. To assess spinopelvic biomechanical parameters; 2. To screen for relative and absolute contraindications; 3. To reassess a patient's progress from some forms of spine altering treatments. Finally, and most importantly, we summarize why the long-held notion of carcinogenicity from X-rays is not a valid argument.

摘要

整脊疗法行业内有一派人强烈反对在脊柱疾病(即半脱位)患者的诊断、治疗和管理过程中常规使用X射线。这些激进分子反复提及一些常见的错误说法,比如“没有证据”支持通过X射线进行脊柱生物力学评估,“没有指南”支持常规成像,还不断宣扬“X射线是危险的”这一论调。这些观点以翻版的对抗疗法“仅红旗”脊柱护理医学指南、评论文章和共识声明的形式出现。在此,我们审视这些常见观点,并给出有力数据反驳此类说法。很快就能明显看出这些说法是错误的。它们基于精心挑选的医学参考文献,而且最重要的是,大量与这种论调相悖的证据仍被忽视。事实上,有相当多的证据支持在整脊疗法和手法治疗中常规使用放射成像用于三个主要目的:1. 评估脊柱骨盆生物力学参数;2. 筛查相对和绝对禁忌症;3. 重新评估患者在某些形式的脊柱矫正治疗后的进展。最后,也是最重要的,我们总结了为何长期以来认为X射线具有致癌性的观念并非一个合理的论据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8544/7883173/8dd94a98b221/10.1177_1559325820984626-fig1.jpg

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