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Cleveland, OH – When Mart Sinclair woke to a high pitched alarm coming from his smartphone, it wasn’t time to get ready for his job training puppies to comfort terminal pediatric cancer patients. It was time to get help. At the same time, a similar alarm was going off in the home of chiropractor Sheila Stamp. Less than an hour later, Sinclair was on a table in Stamp’s clinic and potential disaster had been averted. Sinclair was able to make it to his daughter’s piano recital the next day.

Sinclair is one of a growing number of patients electing to have a small battery-powered device implanted near their spine and designed to monitor for the development of an acute chiropractic subluxation. If detected, the spine can be stabilized by the device until a definitive treatment and payment plan can be arranged with an on call emergency chiropractic provider. Although research is ongoing, preliminary data has shown that use of an implantable desubluxator by certain high risk patients helps to ensure that they are treated within the “Golden Hour” of emergency subluxation management.

But what is a subluxation? How does an implantable desubluxator work? And which patients are most likely to benefit? For answers to these questions, and many more, I turned to a leading expert in the field of emergency spine wellness and nervous system trauma.

“When the human spine is not in a proper alignment, a patient is at risk of going into dyshomeostasis or worse,” Frank Grimes, a chiropractic surgeon near Harvard, explained. “Simply put, you’ve got about an hour before the shit hits the fan, and I’m not talking about just back pain or headaches. I’ve seen a patient’s entire spinal column collapse like an accordion and then comically bob up and down as they shriek in pain. It changes you. Some patients are predisposed, but it can happen to anyone, at any time. You look a little off, do you mind if I check your spine?”

According to chiropractic science, the human body was designed to function perfectly at all times. But if the flow of information from the brain to every cell in the body is compromised by a chiropractic subluxation, we can lose the ability to maintain optimal health. This can result in a variety of health concerns such as lower back pain, headaches, asthma, and even the occasional extra chromosome 13.

While Grimes admits that there have been some disagreements over the exact definition of a chiropractic subluxation, he states that the profession isn’t exactly making it up as they go along:

“Despite what some skeptics may claim, we aren’t flying blind when it comes to spinal health. The best evidence has revealed that subluxations are a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health.

But while having a specific definition upon which to focus diagnostic and treatment interventions is helpful, some mysteries do still remain.

Subluxations are often thought of as a chronic condition, like adrenal fatigue or splenic ennui, and for many they are. But for some people, acute subluxations can be cause extreme symptoms. And despite 125 years of intense study and practice, chiropractors have not figured out a way to know if a newly developed subluxation will result in severe acute disease, cause chronic complaints, or become a latent condition with the possibility of causing problems in the future. Because of this uncertainty, in addition to treating patients with clearly symptomatic subluxations there has also been a focus placed on frequent checks of asymptomatic patients of all ages in order to root out any hidden subluxations.

An implantable desubluxator is not designed to be a replacement for the frequent check ups of the spine recommended by chiropractic organizations to help maintain spinal health. The purpose of the device is to catch an acute subluxation as it occurs in real time, in order to reduce the risk of any severe adverse outcomes in a select population of patients. These are people who may not have the spinal reserves that many of us take for granted.

Grimes says that he only recommends the invasive but potentially lifesaving device for about a quarter of his patients, and so far only a small percentage of those have undergone the procedure. He uses a validated severe acute subluxation risk calculator in order to help determine which patients would be most likely to benefit, but admits that there is an art to the process. “Chiropractic care is complex and every patient has unique variables that I have to take into account. Age, past medical history, and a patient’s comfort with uncertainty are key factors but there is no one size fits all approach with subluxations, except that everyone has one or will eventually have one at some point.”

You’ve probably seen videos where a chiropractor adjusts a patient’s spine, making an audible cracking sound as the bone and surrounding tissue return to a healthy position. An implantable desubluxator works in a similar fashion. Once an abnormal energy signal is detected by the device, which consists of a processing unit placed near the cervical spine and a number of wires running along the spinal column, a series of micropulses are emitted that stabilize the problem area.

Grimes says that the force generated by these micropulses is very light, about the amount required to oscillate an atom of cesium-133 between two hyperfine levels of its ground state. So there is no reason for patients or parents who are wary of aggressive high velocity adjustments to worry:

Other than the general anesthesia, potential for surgical site infection, possible rejection of the device by a patient’s immune system, significant pain during recovery, and the need for battery changes every three to six months, it’s a virtually risk free intervention that I feel very comfortable recommending for infants.

Once a patient has an implantable desubluxator placed by a chiropractic surgeon, the next step is setting up monitoring. Patients can download a smartphone application that syncs with the device in order to sound an alert when a subluxation occurs, and to track various other spinal health parameters such as the rate and rhythm of cerebrospinal fluid flow. And similar to how a home alarm system works, patients will typically sign a contract with a monitoring company, such as the Boston based SpineSafe USA, that in addition to alerting the patient to any abnormal alignments will also arrange for 24-7 emergency chiropractic treatment if necessary.

I revisited Mart Sinclair a week after his acute subluxation was picked up by his implantable desubluxator. Still a bit shaken by the experience, but thankful for a new lease on life, Sinclair was happy to sing the praises of the technology. “I don’t know if I’d be here with this device, and without SafeSpine USA. To me that’s worth any price. Yes, I would recommend it to anyone who is worried about this kind of thing.”

Unplugging the device…

For those of you who actually made it this far, I usually end my satire pieces with a bit of an explanation of what I was targeting and maybe a skeptical pearl or two. I don’t have much to add this time, however.

When I come up with ideas for satire, both here and at the secret fake news blog I’ve had since 2007, I often take a pseudoscientific belief system and wonder what might happen if it was taken seriously. And I mean really taken seriously. Chiropractors who believe in subluxations and claim to save lives, and I know that not all chiropractors fall into this category, believe that they are providing a legitimate service. They act like actual doctors and real doctors devise ingenious ways to diagnose and treat real problems.

So I’m obviously attempting to point out the ridiculous nature of chiropractic philosophy. But another angle to this post was pointing out how bad puff pieces about new medical treatments can be, particularly when the author isn’t a dedicated science or medical journalist. The emotional opening story about a patient who benefited from the new treatment is a nearly ubiquitous component, as is the failure to get input from someone other than a true believer.

But I have to admit that for the most part I just thought the idea of a chiropractic surgeon, and an implanted subluxation detector, was funny. I hope you did as well. Stay safe and have a good weekend.

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Posted by Clay Jones

Clay Jones, M.D. is a pediatrician and a regular contributor to the Science-Based Medicine blog. He primarily cares for healthy newborns and hospitalized children, and devotes his full time to educating pediatric residents and medical students. Dr. Jones first became aware of and interested in the incursion of pseudoscience into his chosen profession while completing his pediatric residency at Vanderbilt Children’s Hospital a decade ago. He has since focused his efforts on teaching the application of critical thinking and scientific skepticism to the practice of pediatric medicine. Dr. Jones has no conflicts of interest to disclose and no ties to the pharmaceutical industry. He can be found on Twitter as @SBMPediatrics and is the co-host of The Prism Podcast with fellow SBM contributor Grant Ritchey. The comments expressed by Dr. Jones are his own and do not represent the views or opinions of Newton-Wellesley Hospital or its administration.