Clinical Chiropractic demonstrates how lateral flexion views of the cervical and thoracic spine can be used to diagnose segmental dysfunction. An obvious concern when taking additional radiographs is the increased patient exposure to ionizing radiation. The value of their use is rated as established in assessment of degenerative, traumatic, or postsurgical instabilities but equivocal for other conditions and circumstances. Procedures with any of rating are approved for use and reimbursement in clinical practice. In my opinion the diagnosis of spinal segmental instabilities can best be determined by static and stress bending views.
Instabilities are often a functional problem.
Dislocation can of course be seen on static films and stress films may be contraindicated in cases of trauma induced dysfunction. The addition of plain film stress bending studies to our clinical exam as doctors of chiropractic should be utilized especially if we intend to diagnose a functional problem such as segmental dysfunction. Intra-and interexaminer reliability of passive motion of the lumbar spine. Roentgenological examination of the functional mechanics of the lumbar spine in lateral flexion. Managing Low Back Pain, 2nd ed.