• Rome P
• Waterhouse J

• Fixation
• Fixation, Vertebral
• Open Access Document
• Subluxation
• Vertebral Subluxation Complex

This narrative review examines the limited and varied interpretation of what constitutes evidence in evidence based chiropractic practice. The authors report a bias towards only one of the three evidential The majority of spinal motion studies appear to focus on the anterior vertebral motor unit. This paper discusses the  vertebral  subluxation  (VS)  element  of  segmental  dysfunction  within  a  facet’s  centrode  in  relation  to mechanical articular fixation along the path of instantaneous axes of motion. In effect, there would be three segmental  axes  of  motion,  one  through  the  vertebral  body,  and  two  within  each  zygapophyseal  joint. Discussion is offered here on the loss of facet joint motion identified as a vertebral fixation as being but one of a complex of factors comprising a vertebral subluxation (VS). It is appreciated that a change in segmental motion  such  as  a  vertebral fixation  would  affect  all  axes.  It  is  generally  accepted  that  mechanically,  a vertebra may be fully fixated (locking), partially fixated, or subject to aberrant (erratic) motion. There is also a classification of a hypermobile subluxation – a condition not addressed in this dissertation. In essence, a VS may  comprise  varying  degrees  of  dysfunction,  displacement  and  somatosensory  activation.  It  is  seen  here as  a  more  complex  consideration  than  just  a  minor  mechanical  disturbance.  Lineal  displacement  and rotation  may  vary  considerably  depending  on  the  spinal  region.  Somato-autonomic  stimulation  may  be initiated   by   activated   somatosensory   sensations   such   as   nociceptors,   mechanoreceptors   and proprioceptors. As noted by the World Health Organisation (WHO) definition, there are three main elements in   the   chiropractic   model   of   a   vertebral   subluxation.   This   discussion   is   presented   to   explore   the pathophysiological fixation element of the dysfunction in the segmental subluxation. It may be regarded as a relatively common form of dysfunction attended by chiropractors and others. The fixation has been adopted elsewhere  under  such  synonyms  as  blockage,  dysfunction,  locking  and  blockade.  Theories  regarding  the biological mechanism of a fixation are discussed and our preferred hypothesis of negative pressure (suction or adhesiveness) resulting in contraction of the articulating surfaces.

Author keywords: Vertebral subluxation - Facet fixation - Segmental fixation - Vertebral subluxation complex (VSC)

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