Technic and Practice of Chiropractic

by Joy Maxwell Loban

According to the usage of earlier writers on subluxations this term (lateral displacement) included rotation of the vertebra as well as those changes in position in which the whole or nearly all of the vertebra deviates sidewise from its normal position. Since the introduction of the term “rotation” into the description of subluxations, the meaning of the term “lateral displacement” is much more restricted. It refers now to a condition which probably occurs in the strictest sense only in the Cervical region, most frequently with the first and second Cervical, the two being subluxated together.

We have already stated that the most important fact to be determined regarding the Atlas is its lateral displacement, since this produces the greatest impingement of nerves. Lateral displacement of any other Cervical can best be judged by examination of the transverse processes, since by palpation of the spinous process alone it is quite impossible to distinguish between lateral and rotary subluxation.

In the Dorsal and Lumbar regions the R or L used to describe the position of the spinous process most often indicates rotation of the vertebra. While it is perfectly proper thus to describe the subluxation on a record, in the determining of the form of adjustment to be used the position of the whole vertebra must be considered.

Anterior Subluxations

Forward displacements may occur anywhere in the spine. In the case of the first Cervical they are usually, though not always, forward displacements of only one side—rotation—though the whole Atlas may be anterior if the Axis has moved with it or is tipped so that the spinous process is much superior. This is rare.

Any Cervical may be anterior; usually a series are anterior (if any) amounting to an increase in the Cervical curve—a lordosis. This condition may be corrected by transverse adjustments given from the front and side.

A Dorsal vertebra is only relatively anterior, the adjacent ones being relatively posterior, and the only possible correction at present is the adjustment of the posterior ones. A Lumbar cannot be anterior unless those below it are also anterior, on account of the locking of articulations. Discovery of anterior Lumbars is quite common. The fifth Lumbar may be subluxated anteriorly by slipping forward on the Sacrum; it must be superior at the same time, on account of the shape of the articulating surfaces which face downward and forward. The spinous process is crowded closely against the fourth while the body of the fifth is too widely separated from that of the fourth.

Posterior Subluxations

There are many Chiropractors who have always considered the posterior subluxation more than any other, not because it produces greater nerve impingement than others but because it is easiest to detect; it intrudes itself upon the attention of the unskilled examiner most persistently. Nor should its importance be underestimated, though we now realize that in some instances a rotated or anterior vertebra may cause more nerve impingement than a posterior one.

The posterior subluxation in the lower Dorsals and Lumbars is the easiest variety to adjust; in this region a posterior displacement of one vertebra tends to bring with that one the next adjacent superior one, the sharpest deviation occurring between the posterior one and the one below it.