ReviewChiropractic & manual therapies2020
The clinical utility of routine spinal radiographs by chiropractors: a rapid review of the literature.
Review in Chiropractic & manual therapies, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 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
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 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
- Long-term stability of reducing cervical kyphosis via Chiropractic BiophysicsJournal of physical therapy science · 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
- 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
- Plain Radiography: A Unique Component of Spinal Assessment and Predictive Health.Healthcare (Basel, Switzerland) · 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
- 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
- Don't Throw the 'Bio' out of the Bio-Psycho-Social Model: Editorial for Spine Rehabilitation in 2022 and Beyond.Journal of clinical medicine · 2023Article
- The treatment and rationale for the correction of a cervical kyphosis spinal deformity in a cervical asymptomatic young female: a Chiropractic BioPhysicsJournal of physical therapy science · 2023Article
- Examining Clinical Opinion and Experience Regarding Utilization of Plain Radiography of the Spine: Evidence from Surveying the Chiropractic Profession.Journal of clinical medicine · 2023Article
- An investigation into chiropractic intern adherence to radiographic guidelines in clinical decisions with a descriptive comparison to clinical practitioners.The Journal of chiropractic education · 2023Article
- Does Improvement towards a Normal Cervical Sagittal Configuration Aid in the Management of Lumbosacral Radiculopathy: A Randomized Controlled Trial.Journal of clinical medicine · 2022Article
- Adherence to spinal imaging guidelines and utilization of lumbar spine diagnostic imaging for low back pain at a Canadian Chiropractic College: a historical clinical cohort study.Chiropractic & manual therapies · 2022Article
- Factors affecting chiropractor requests for full-length spinal radiography: A scoping review.Journal of medical radiation sciences · 2022Article
- Exploring factors influencing chiropractors' adherence to radiographic guidelines for low back pain using the Theoretical Domains Framework.Chiropractic & manual therapies · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWhen indicated by signs or symptoms of potentially serious underlying pathology (red flags), chiropractors can use radiographs to inform their diagnosis. In the absence of red flags, the clinical utility of routine or repeat radiographs to assess the structure and function of the spine is controversial.
objectivesTo determine the diagnostic and therapeutic utility of routine or repeat radiographs (in the absence of red flags) of the cervical, thoracic or lumbar spine for the functional or structural evaluation of the spine. Investigate whether functional or structural findings on repeat radiographs are valid markers of clinically meaningful outcomes. The research objectives required that we determine the validity, diagnostic accuracy and reliability of radiographs for the structural and functional evaluation of the spine. EVIDENCE REVIEW: We searched MEDLINE, CINAHL, and Index to Chiropractic Literature from inception to November 25, 2019. We used rapid review methodology recommended by the World Health Organization. Eligible studies (cross-sectional, case-control, cohort, randomized controlled trials, diagnostic and reliability) were critically appraised. Studies of acceptable quality were included in our synthesis. The lead author extracted data and a second reviewer independently validated the data extraction. We conducted a qualitative synthesis of the evidence.
findingsWe identified 959 citations, screened 176 full text articles and critically appraised 23. No relevant studies assessed the clinical utility of routine or repeat radiographs (in the absence of red flags) of the cervical, thoracic or lumbar spine for the functional or structural evaluation of the spine. No studies investigated whether functional or structural findings on repeat radiographs are valid markers of clinically meaningful outcomes. Nine low risk of bias studies investigated the validity (n = 2) and reliability (n = 8) of routine or repeat radiographs. These studies provide no evidence of clinical utility.
conclusionWe found no evidence that the use of routine or repeat radiographs to assess the function or structure of the spine, in the absence of red flags, improves clinical outcomes and benefits patients. Given the inherent risks of ionizing radiation, we recommend that chiropractors do not use radiographs for the routine and repeat evaluation of the structure and function of the spine.
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.