A New Way to Evaluate NRC Type Patients thru X-Ray Analysis

Dr. Robert DeMartino, D.C., Q.N.Master Trainer for NRCT

Superior Health SolutionsHenderson, NV

How I Found This

• A friend told me about this online course that explained in great deal the ligament issues that someone would sustain in an MVA.

• Upon watching it hit me that this could be involved with NRC type patients.

• I began going back and x-raying them to see if it was applicable and found it present in the majority of cases.

George’s Line

Case History

• 66 Year old female• 3 Strokes within the last five years• Left side of the body weakness• Balance problems• Pain in both legs• Neck pain• Middle back pain

Cervical Lateral View w/ Extension

What was her listing?

• C4 is retro unstable on C5• Bilateral Posterior!• It makes sense, because if the ligament

instability in her spine is on the posterior aspect, than the translation of the bones will be in a posterior position.

• Therefore, the force of the NRC treatment should be applied Posterior to Anterior.

Case History

• 24 year old female• Diagnosis of Still’s Disease (essentially Juvenile

RA with associated high fevers).• Chronic whole body pain.• Onset when she was 16 years old following a

“routine” surgery on a knee injury.

Cervical Lateral View w/ Flexion

What was her listing?

• C3 is unstable on C4 anteriorly.• Less so C2/3 and C4/5.• Bilateral Anterior!• Since the ligament damage is occurred in the

anterior position, it would make logical sense that the nervous system would respond to the Anterior to Posterior line of drive.

• But here is where it gets interesting…

The New X-Ray Angle

• It is a twist on taking an AP open mouth cervical x-ray.

• You set the patient up the exact same way, but you take the x-ray with the patient laterally bending their neck bringing their ear directly to the shoulder.

• Take it with the bend to both sides.• You are looking for an overhang of the C1

lateral mass over the body of C2.

AP Open Mouth w/ Lateral Bend

Normal Example

Case History

• 16 year old• Diagnosed with fibromyalgia• Onset of symptoms came after she crashed

her bike into a light pole and fractured her collarbone

• Here are her APOM Lateral Bend X-rays

APOM w/ Lateral Bend

Case History

• 55 year old woman• 30 years ago her car was T-boned by a semi-

truck that broke multiple bones in her body.• Her pain was controlled with traditional

chiropractic for a long time, but within the last few years she has gotten little to no relief with any modality.

APOM w/ Lateral Bend to Left

APOM w/ Lateral Bend to Right

Clinical Implications

• A more precise way to improve diagnosis.• A visual for patients so they can understand.• Allow for a higher level of diagnosis code.• Explains why some patients will get changes on

Anterior and Posterior testing.• Explains why the lateral technique works.• Helps get more specific with treatment giving you

a more exact line of drive.• Adds another component of care with cervical

stabilization techniques necessary.