1. A New Way to Evaluate NRC Type Patients thru X-Ray Analysis Dr. Robert DeMartino, D.C., Q.N. Master Trainer for NRCT Superior Health Solutions Henderson, NV

2. How I Found This A friend told me about this online course that explained in great deal the ligament issues that someone would sustain in an MVA. Upon watching it hit me that this could be involved with NRC type patients. I began going back and x-raying them to see if it was applicable and found it present in the majority of cases.

3. George’s Line

4. Case History 66 Year old female 3 Strokes within the last five years Left side of the body weakness Balance problems Pain in both legs Neck pain Middle back pain

5. Cervical Lateral View w/ Extension

6. What was her listing? C4 is retro unstable on C5 Bilateral Posterior! It makes sense, because if the ligament instability in her spine is on the posterior aspect, than the translation of the bones will be in a posterior position. Therefore, the force of the NRC treatment should be applied Posterior to Anterior.

7. Case History 24 year old female Diagnosis of Still’s Disease (essentially Juvenile RA with associated high fevers). Chronic whole body pain. Onset when she was 16 years old following a “routine” surgery on a knee injury.

8. Cervical Lateral View w/ Flexion

9. What was her listing? C3 is unstable on C4 anteriorly. Less so C2/3 and C4/5. Bilateral Anterior! Since the ligament damage is occurred in the anterior position, it would make logical sense that the nervous system would respond to the Anterior to Posterior line of drive. But here is where it gets interesting…

10. The New X-Ray Angle It is a twist on taking an AP open mouth cervical x-ray. You set the patient up the exact same way, but you take the x-ray with the patient laterally bending their neck bringing their ear directly to the shoulder. Take it with the bend to both sides. You are looking for an overhang of the C1 lateral mass over the body of C2.

11. AP Open Mouth w/ Lateral Bend Normal Example

12. Case History 16 year old Diagnosed with fibromyalgia Onset of symptoms came after she crashed her bike into a light pole and fractured her collarbone Here are her APOM Lateral Bend X-rays

13. APOM w/ Lateral Bend

14. Case History 55 year old woman 30 years ago her car was T-boned by a semi- truck that broke multiple bones in her body. Her pain was controlled with traditional chiropractic for a long time, but within the last few years she has gotten little to no relief with any modality.

15. APOM w/ Lateral Bend to Left

16. APOM w/ Lateral Bend to Right

17. Clinical Implications A more precise way to improve diagnosis. A visual for patients so they can understand. Allow for a higher level of diagnosis code. Explains why some patients will get changes on Anterior and Posterior testing. Explains why the lateral technique works. Helps get more specific with treatment giving you a more exact line of drive. Adds another component of care with cervical stabilization techniques necessary.