Introduction
X-ray alignment, placement, and analysis are the three pieces to calculating the perfect correction vector. Alignment of your x-ray machine is the first step. It is a cumbersome process but once completed it is checked semi-annually. The analysis is a mechanical process based on the honor system. It involves learning to see structures and their visual relationship to the each other based on symmetry. It is a process that once learned is rarely challenging. Both of these are static processes. The X-ray machine is bolted together once aligned and analysis of the cervical x-ray series is a snapshot in time and non-movable. This differs from the x-ray placement. It has many moving parts which makes placement a dynamic process that involves an advanced understanding to duplicate the misaligned body and to find balance on a film. Anyone that has taken an UC (Upper Cervical Film) film knows the difficulty and many questions that arise as you are positioning the patient. This is the focus here and requires a discussion to an old process and its mathematical validity.
Groundwork
The human frame is a live and dynamic structure. When we move, everything is reactive to create balance. This occurs when we walk, sit, stand and even when we cross our arms. Our bodies recalibrate to the slightest deviations to maintain a perfect state of equilibrium.
There are three sub-structures of the human frame:
- The pelvis to the C2 vertebra
- The C1 vertebra (the coupling)
- And finally the skull
My contention has always been that the skull and the atlas are the balancing mechanism for our upright human bi-ped (C2-Pelvis).
The purpose here is not to examine this in too much detail, but to highlight some of the major premises that outline this position. The double cup of the atlas (C1) allows:
- The skull to deviate in all three planes (upper cup)
- The atlas to side slip and rotation on top of the lower angle (lower cup)
This is all in response to the deviation to the lower angle (C2-Pelvis). The non-locking joint (C1) allows the 12-15 lb skull to be a perfectly reactive balancing mechanism to the moving and deviating lower system (C2-Pelvis). As one ends moves the other balances. This is the function known as the ‘righting reflex.’ The statement that the C1 is merely a mechanical coupling in dynamic system is a reality.
The C2- pelvis (lower angle) is the misaligning structure
And the atlas and skull act the balancers
This deductive approach opens a new conceptual understanding in patient placement and analysis for the Vertex and Nasium. This is the concept called creating a relative zero.
History
UC placement places the body in its misaligned position without establishing a zero axis to measure to or from. This means all the structures are measured arbitrarily in space. The skull to the atlas, the atlas to the lower neck, and the upper angle (laterality) to the lower angle measurements are only deviations from each other. This is a mathematically inaccurate approach because the present patient placement and subsequent analysis do not use a relative zero protocol. The argument that the center of the foramen magnum or the center skull quantifies as a zero reference point is bogus because they are misaligned. The fact that structures are not at 3-D zero (the definition of misalignment) and off the vertical defines a non-zero reference and approach. The answer cannot be to jam structures because this skews the misalignment.
A method, which sets the misalignment and analyzes on a zero axis will produce an optimal correction vector.
At present, the vector only corrects structure to structure and not to a zero position.
Follow this simple number example of why creating a zero point is absolutely necessary to the optimal correction vector:
- The number 5 is 2 units away from the number 3. If we measure in relationships and not from a zero position we will calculate a 2 and not the 5. The present UC analysis is built on this relationship measurement and not on a zero axis. The present measuring procedure only creates a vector to move the 5 only 2 units. This would leave us off zero at a three.
True accuracy of where a structure or set of structures exists to a zero point is essential to create a vector that incorporates a placement and an analysis to and from a zero axis.
Enough Fudging
As discussed, the present placement is only one that measures one structure to another and not from a zero axis. This will only calculate a vector that corrects one structure to another an not to Cartesian zero. This is apparent in any advanced biomechanics discussions and the continual manipulation of vector with ‘fudges factors.’
This has to stop if we are to do more than leg check reliability and ‘Feel good’ research, which does not validate the premises of our measurement work.
One More Piece
The three structures of the human frame are again the skull, C1, and the lower angle (C2- Pelvis). The two balancers or compensators are the C1 and the skull. This is clear based on the shape, size and mass of these structures, the coupling joint design, and most importantly the end orientation of the C1 and the skull. As the body moves, the free moving joint design of the skull and C1 are reactive to the opposite end of the feet fixed position. It is the skull that has the three-dimensional reign. There is no other joint in the body that has the ability to move in this three dimensional space at such ranges.
Patient Placement and the laser
From the beginning of vector based x-ray positioning, the skull is centered and secured with head-clamps. This creates an erroneous zero position because the skull is placed on the center of the film in its misaligned position. You can’t use an off zero off vertical structure to measure as a reference and expect to have reliable outcome. Another point to discuss is the structures that are balancers and the structures that are prime movers.
The skull is only one of the two balancers and thus only represents half of the equation. It is obvious that if you have three structures and you clamp half of the balancers in place, the result will be partial. This is difficult to explain but if you visualize a 2 by 4 piece of wood leaning off vertical and two other pieces of wood atop of the 2 by 4. These two top pieces are responsible to balance the leaning 2 by 4 below.
One primary off center (lower angle) topped by two balancing
structures above (C1 and Skull)
So, the two pieces alone only represent a percentage or partial total of the whole. It does not represent the whole and can never by itself give the information to calculate the total. This is analogous to using the skull as representative for the true correction vector. It has two faults. The first being its misaligned position and secondly its being one of the two balancers. This is a fascinating concept. Mathematically the simple equation would look like this:
Balancers = Misalignment
Which can be extrapolated out to:
Skull + C1 = Lower Angle (C2 – Pelvis)
Using this profound information, the mathematical resolution is to set the lower angle on zero and measure the C1 and skull to this true relative zero. This process would place the pelvis to C2 in 3D zero position. This would result in the ability to measure the x, y, and z-axis deviation off true zero of C1, and lead the skull to more of a calculated vector.
Now that is hot!!!! Next month get the protocol.
Russell Friedman DC
7/3/11
