ReviewChiropractic & manual therapies2018
Current evidence for spinal X-ray use in the chiropractic profession: a narrative review.
Review in Chiropractic & manual therapies, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 1 synthesis or guideline pooled it, 75 citations in OpenAlex.
- Clinical Practice Guideline for Best Practice Management of Pediatric Patients by Chiropractors: Results of a Delphi Consensus Process.Journal of integrative and complementary medicine · 2024Guideline
- Does radiographic imaging for spinal pain in patients receiving chiropractic care change patient outcomes? A pilot randomised controlled trial.Chiropractic & manual therapies · 2026Trial
- The association between individual radiographic findings and improvement after chiropractic spinal manipulation and home exercise among older adults with back-related disability: a secondary analysis.Chiropractic & manual therapies · 2025Trial
- Reliability of the Biomechanical Assessment of the Sagittal Thoracic Spine on Radiographs Used in Clinical Practice: A Systematic Literature Review.Bioengineering (Basel, Switzerland) · 2026Review
- The Reliability of Biomechanical Mensuration Methods of the Sagittal Cervical Spine in Radiography Used in Clinical Practice: A Systematic Review of the Literature.Journal of clinical medicine · 2026Review
- The UQTR university-based chiropractic clinic cohort (UQTRChiCo): description and summary of an available data source for research collaborations.Chiropractic & manual therapies · 2026Article
- Long-term stability of reducing cervical kyphosis via Chiropractic BiophysicsJournal of physical therapy science · 2026Article
- Patient safety culture of chiropractors and variables predictive of overall patient safety rating: Response to an adapted version of the Survey on Patient Safety Culture Medical Office Survey.Journal of chiropractic medicine · 2026Article
- Sensitivity and Specificity of Elliptical Modeling and Sagittal Lumbar Alignment Variables in Normal vs. Acute Low Back Pain Patients: Does Pelvic Morphology Explain Group Lordotic Differences?Healthcare (Basel, Switzerland) · 2025Article
- The changing face of acute low back pain management by physiotherapists, osteopaths and chiropractors in the UK: a 20-year comparison from 2003 to 2023.BMC musculoskeletal disorders · 2025Article
- Variation in use of radiographs in chiropractic care: a cross-sectional study.Chiropractic & manual therapies · 2025Article
- Improvement in Chronic Low Back and Intermittent Chronic Neck Pain, Disability, and Improved Spine Parameters Using Chiropractic BioPhysicsHealthcare (Basel, Switzerland) · 2025Article
- Risk and Safety in Radiographic Utilization: Evaluating the Evidence From Current Research.Radiology research and practice · 2025Review
- Diagnostic imaging in the management of older adults with low back pain: analysis from the BAck Complaints in Elders: Chiropractic - Australia cohort study.Chiropractic & manual therapies · 2024Article
- Compliance with evidence-based radiographic imaging guidelines by chiropractic interns at a chiropractic training program.The Journal of chiropractic education · 2024Article
- Article
- Reliability of the Biomechanical Assessment of the Sagittal Lumbar Spine and Pelvis on Radiographs Used in Clinical Practice: A Systematic Review of the Literature.Journal of clinical medicine · 2024Review
- Chiropractors' perceptions on the use of spinal radiographs in clinical practice: a qualitative study.Chiropractic & manual therapies · 2024Article
- A modern way to teach and practice manual therapy.Chiropractic & manual therapies · 2024Review
- An investigation into the chiropractic practice and communication of routine, repetitive radiographic imaging for the location of postural misalignments.Journal of clinical imaging science · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The use of routine spinal X-rays within chiropractic has a contentious history. Elements of the profession advocate for the need for routine spinal X-rays to improve patient management, whereas other chiropractors advocate using spinal X-rays only when endorsed by current imaging guidelines. This review aims to summarise the current evidence for the use of spinal X-ray in chiropractic practice, with consideration of the related risks and benefits. Current evidence supports the use of spinal X-rays only in the diagnosis of trauma and spondyloarthropathy, and in the assessment of progressive spinal structural deformities such as adolescent idiopathic scoliosis. MRI is indicated to diagnose serious pathology such as cancer or infection, and to assess the need for surgical management in radiculopathy and spinal stenosis. Strong evidence demonstrates risks of imaging such as excessive radiation exposure, overdiagnosis, subsequent low-value investigation and treatment procedures, and increased costs. In most cases the potential benefits from routine imaging, including spinal X-rays, do not outweigh the potential harms. The use of spinal X-rays should not be routinely performed in chiropractic practice, and should be guided by clinical guidelines and clinician judgement.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.