Chiropractic Forensics Library
William Cockburn,D.C.

Cervical Curve Angle
William Cockburn,D.C.

note:  The following is a reply to an annonymus e-mail that I thought had value to the readers of this site

Anonymous Wrote:

<<<Dr. Cockburn, I think that your statements at last nights seminar are

rediculous. I have been using x-ray menstruation for over thirty years. I

can tell you from clinical experience, that every line of menstruation "IS

ACCURATE AND RELIABLE". Take cervical lordosis angle for determining loss

of curve in whiplash cases as proof whiplash exists. While some refer to

you as an expert in biomechanics and forensics, I think you need to get

educated.>>>

Dear Anonymous

I usually do not respond to annon. messages, but you have provided some

fruit for discussion that is important, and thus, this email post will be

uploaded to chirosci-list and chiro.org.

First of all, the "clinical experience" you speak of, while valuable, is of

no benefit if your paradigm is wrong and you are unwilling, or incapable of

"shifting" in the light of evidence.

I do not consider myself an expert in anything. I am just a DC trying to

better myself and provide the best continuity of patient care possible,

especially in this emerging managed care vs cash practice model.

Now to biomechanics and lines of mensuration. You have eloquently pointed

out the flaw in your own thinking. Lines of mensuration do indeed have

clinical utility. But only some of them, and only in concert with other

observations and diagnostic routines. Soon I will be publishing at

Chiro.org a list of reliable and unreliable measurements with references for

each on the forensics page, For now I will point out just one "flaw" in

your thinking, hopefully to the benefit of others if not for yourself.

CERVICAL LORDOSIS ANGLE:

This angle is made by drawing a line through the atlas plane from the

center point of the anterior tubercle through the posterior arch. A second

line is constructed by drawing a line through the lower epiphyseal plate of

C7 (if you have good technique and can even see C7), both lines converging

to the posterior. Perpeniculars to these two lines are then constructed and

the angle is then measured .

A loss of cervical lordosis is indicated if this angle is increased.

QUESTION: Given that the radiographic techinique in exposing the film is

accurate, and given that the appropriate landmarks on the film are selected,

and given that the construction of lines and angles is accurate

(eyeballing), and given that your protractor is calibrated for easy

visibiluty (not one from the five and dime store,

WHAT IF THE ATLAS OR C7 IS FIXED IN FLEXION OR EXTENSION??

Hmm...

Did you ever attempt to determine this before nullifying your mesaurement.

Did you ever attempt to dertemine how this disrelationship would affect the

mensuration? Are you aware of conversion factors for correcting the

abberant measurent? Or do you jsut draw a line through two bones and rely

upon the outcome?

Hmmm.

Lines fo measurement have their place, that is a given. How much we rely

upon our techniques and observations and judgement is where these

measurements sink or swim.

Finaslly, menstruation is a normal physiologic process in females and has

nothing to do with biomechanic analysis of x-rays. I am sure this was just

a typo, wasn't it?

William Cockburn, D.C., F.I.A.C.T., B.C.F.E.

Diplomate Forensic Examiner

                                                      "Truth Comes From Within"