Magnetic Resonance Angiography Research
Dispels False Rumors
that Cervical Manipulation Might Cause CVAs
and MRI Research Proving Chiropractic
can Improve Spinal Subluxation and Disc
One more time... they did it again! Vincent
Esposito, D.C. and Carmine Esposito, D.C. together with Arnold E. Cianciulli,
D.C. and Neil Goldberg, M.D. were honored with the extremely prestigious
"1995 Annual Research Award" by the Sacro Occipital Research Society
International (SORSI). This international organization promotes research
advances in Chiropractic and is currently celebrating its seventieth anniversary
while Chiropractic celebrates its centennial birthday.
Dr. Cianciulli, past president and present
member of the board of directors of the National Chiropractic Mutual Insurance
Company (NCMIC), chairman of the educational committee of the Foundation for
Chiropractic Education and Research (FCER), and member of the National
Chiropractic Health Care Advisory Committee to the Clinton administration, was
extremely frustrated by the unscientific rumors that had been promoted by a
group of neurologists alleging manipulation might be associated with CVAs. Their
'research' was based on a hand count as to the frequency of CVAs caused by
cervical manipulation. This poll was taken at one of their meetings. Dr.
Cianciulli was shocked by their total disregard for the scientific method and
their anecdotal conclusions.
After brainstorming with the Espositos,
relating to how they could formulate some hard, honest, scientific evidence that
Chiropractic does or does not cause cerebrovascular accidents, the three joined
forces with Dr. Goldberg, a medical neuroradiologist. A research project was
developed that took advantage of the diagnostic capabilities of Magnetic
Resonance Angiography (MRA) and Color Duplex Doppler Ultrasound vascular dynamic
flow studies. The patients were studied in the extremes of cervical ranges of
motion for extended periods of time. This was compared to the baseline neutral
anatomical position for any decrease of changes of carotid and/or vertebral
artery flow through the circle of Willis. Patients with a variety of clinical
presentations were studied and no one demonstrated any abnormal changes in
cervico-cranial arterial flow during any ranges of motion studied.
This is the second consecutive year that Dr.
Carmine Esposito, and the third consecutive year that Dr. Vincent Esposito have
received this prestigious award.
Dr. Vincent Esposito's research dates back to
1983 at which time he demonstrated improvements on pre and post MRI
studies with patients exhibiting disc diseases.
In 1977, Dr. Carmine Esposito began his
research, leading to the development of Range of Function Technique. This
approach combines phases of many Chiropractic techniques. One aspect of the
technique is a variation of DeJarnette's pelvic and orthopedic blocking, which
allows any of the patient categories to be blocked in the supine position. This
lends most naturally to most MRI machines where the patient is best studied, in
situ, within the MRI machine, during the adjustment. Doing MRI studies on
patients, while being adjusted on blocks, has afforded a unique opportunity to
get a glimpse at what exactly happened during a Chiropractic adjustment.
The Esposito brothers have been able to study
and show positive results in a variety of conditions such as intervertebral disc
desiccation, intervertebral disc degeneration, intervertebral disc rupture,
intervertebral disc bulge, protruded discs, extruded discs, sequestered discs,
focal disc herniations, (with and without thecal impingement), central disc
herniations, discal encroachment of the intervertebral foramina, hyper and
hypolordosis, hyper and hypokyphosis and scoliosis.
Also pre and post cranial manipulation was
studied demonstrating changes in intracranial architecture coupled with positive
changes in objective signs and tests amd amelioration of the patient's
The Espositos have been utilizing cine-MRI to
document changes in cerebrospinal fluid flow during, immediately post, and seven
weeks post the Chiropractic adjustment. Changes in signal intensity, implying
changes in function and structure have been documented. These are innovative
techniques creating new application for the use of the technology of MRI.
Drs. Carmine and Vincent Esposito are
presently well into the review process with FCER, in an attempt to receive a
grant for a research proposal involving disc studies, Chiropractic care and MRI.
Also, the Drs. Esposito are joining forces with Dr. Gary D. Hack, assistant
professor from the University of Maryland, who has discovered muscle-dural
connections at the craniovertebral junction and throughout the cervical spine
via a tiny web of fibrous tissue. His research team was intrigued when they
noticed that when imitating contraction of the rectus capitus posterior minor
muscle caused movement in the dura mater and the CSF as far away as the pons. He
feels that his work and that of the Esposito's, truly complement each other. His
anatomical findings support the MRI changes found by the Espositos. Together,
the three doctors are apllying for a grant from FCER to prove the relationship
between adjusting, CSF flow, discal improvement and headache relief.