Magnetic Resonance Angiography Research Dispels False Rumors

that Cervical Manipulation Might Cause CVAs and MRI Research Proving Chiropractic

can Improve Spinal Subluxation and Disc Diseases.

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 symptomatology.

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.

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