CPAP 1505 Models of Vertebral Subluxation-A Review

CPAP 1505 Models of Vertebral Subluxation-A Review - REVIEW...

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Historical Considerations The term “subluxation” has a long history in the healing arts literature. According to Haldeman 1 it was used at the time of Hippocrates, 2 while the earliest English definition is attributed to Randall Holme in 1688. Holme 3 defined subluxation as “a dislocation or putting out of joynt.”Watkins 4 and Terrett 5 refer to a 1746 definition of the term.The matter is further complicat- ed by the diverse array of alternative terms used to describe sub- luxations. Rome 6 listed 296 variations and synonyms used by medical, chiropractic, and other professions. Rome concluded the abstract of his paper by stating,“It is suggested that, with so many attempts to establish a term for such a clinical and biolog- ical finding, an entity of some significance must exist.” The possible neurological consequences of subluxation were described by Harrison in 1821, as quoted by Terrett 5 :“When any of the vertebrae become displaced or too prominent, the patient experiences inconvenience from a local derangement in the nerves of the part. He, in consequence, is tormented with a train of nervous symptoms, which are as obscure in their origin as they are stubborn in their nature. ..” Although medical authori- ties acknowledge that neurological complications may result from subluxation, 7 classical chiropractic definitions mandate the presence of a neurological component. D. D. Palmer and B. J. Palmer 8 defined subluxation as follows: “A (sub)luxation of a joint, to a Chiropractor, means pressure on nerves, abnormal functions creating a lesion in some portion of the body, either in its action,or makeup.”According to Stephenson’s 1927 text, 9 the following must occur for the term “vertebral subluxation” to be properly applied: 1. Loss of juxtaposition of a vertebra with the one above, the one below, or both. 2. Occlusion of an opening. 3. Nerve impingement. 4. Interference with the transmission of mental impulses. As Lantz 10 noted, “Common to all concepts of subluxation are some form of kinesiologic dysfunction and some form of neurologic involvement.” Component Models of Subluxation Dishman 11 and Lantz 12-13 developed and popularized the five component model of the “vertebral subluxation complex” attributed to Faye. 10 However, the model was presented in a text by Flesia 14 dated 1982, while the Faye notes bear a 1983 date. The original model has five components: 1. Spinal kinesiopathology 2. Neuropathology 3. Myopathology 4. Histopathology 5. Biochemical changes. The “vertebral subluxation complex” model includes tissue specific manifestations described by Herfert 15 which include: 1. Osseous component 2. Connective tissue involvement, including disc, other liga- ments, fascia, and muscles 3.The neurological component, including nerve roots and spinal cord 4.Altered biomechanics 5.Advancing complications in the innervated tissues and/or the patient’s symptoms.This is sometimes termed the “end tissue phenomenon” of the vertebral subluxation complex. Lantz
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CPAP 1505 Models of Vertebral Subluxation-A Review - REVIEW...

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