Published Jun 13, 2017
Peter Rome


INTRODUCTION:  This discussion seeks to highlight the many terms that have been used in the literature and other sources relating to elements of a Vertebral Subluxation Complex (VSC) and the manual healing sciences, particularly chiropractic. BACKGROUND: The term VSC is considered here as the most appropriate of the designations in general use, as it encompasses other identified components, not just a vertebral subluxation (displacement). However, despite alluding to this apparent and common clinical entity, no single term has been unanimously adopted to represent the VSC. METHOD: The variety and frequency of terms and expressions identifying with a vertebral subluxation and spinal manipulation, became apparent while reading research papers for other purposes. As appended, tables have been devised to categorise key components of the VSC.REVIEW: Papers from all the health professions which encompass spinal manipulation to varying degrees, are cited. These include chiropractic, osteopathy, medicine and physiotherapy references. All have developed a variety of terms identifying this physical biological entity, and for the procedure used to address it. Authors have devised this wide variety of terms to designate essentially the same clinical finding of a subluxation, or elements of it. Unanimous acceptance of the VSC premise still seems somewhat limited.DISCUSSION. It is astounding to find over 500 terms relating to aspects of the same clinical entity. One would be challenged to find any other entity that attracts even just 10% of that number of similes - especially a biological one. Many authors from the range of professions seem to have staked a claim in naming this clinical finding, yet universal recognition and acceptance of a single term seems to be slow to materialise. Despite such a proliferation of terms in the literature referring to this clinical finding, one would expect it to be more readily recognised and incorporated into standard textbooks.CONCLUSION. To attract so many terms for the same entity should emphasise its importance in health care. However, it is perplexing in that so many terms tend to dilute the significance of such a common and clinically important finding. (Chiropr J Australia 2017;45:73-89)
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Medical Terminology

1. Gatterman MI. Foundations of chiropractic – Subluxation. 2nd ed. St Louis, Miss. Elsevier Mosby. 2005;6-7.
2. Rome PL. Usage of chiropractic terminology in the literature: 296 ways to say “subluxation”: complex issues of the vertebral subluxation. Chiropr Tech. 1996;8(2):49-60.
3. Palmer DD. The chiropractors adjustor. Portland: Portland Printing House Co; 1910.
4. Dorland’s Illustrated Medical Dictionary. 24th edn. WB Sanders Company, Philadelphia. 1965. p267.
5. Leach RA. The chiropractic theories. Principles and clinical applications. 3rd Edn. Baltimore: Williams & Wilkins 1994.
6. Sato A, Sato Y, Schmidt RF. The impact of somatosensory input on autonomic functions.. In: Reviews of Physiology Biochemistry and Pharmacology. Blaustein MP et al Eds. Springer-Verlag, Berlin. 1997;v130.
7. Haldeman S. Principles and practice of chiropractic. 2nd edn. Norwalk, Conn. Appleton & Lange, 1992.
8. Gatterman MI.1 p198.
9. Leach RA.5 p374.
10. Gatterman MI. The vertebral subluxation syndrome: Is a rose by another name less thorny. J CCA. 1992;35(2):102-104.
11. Gatterman MI. Whiplash: a patient-centred approach to management. St Louis: Elsevier Mosby.2012.
12. Kapandji IA. The physiology of joints. Vol Three, The trunk and vertebral column. Edinburgh: Churchill Livingstone; 1974.
13. Watkins RJ. Subluxation terminology since 1746. J Canad Chiropr Assn. 1968;Fourth quarter:20-24.
14. Bolton PS, Budgell BS. Spinal manipulation and spinal mobilization influence different axial sensory beds. Med Hypotheses 2006:66(2):258-262.
15. Budgell B, Sato A. The cervical subluxation and regional blood flow. J Manipulative Physiol Ther 1997;20(2):103-107.
16. Henderson CNR, Gregory D, Cramer GD; Zhang Q, DeVocht JW, Fornier JT, Introducing the external fixation link for studying spine fixation and misalignment: Part II – Biomechanical features. J Manipulative Physiol Ther 2007;30(3):239-245.
17. King HH, Jänig W, Patterson MM. The science and clinical application of manual therapy. Edinburgh. Churchill Livingstone Elsevier.
18. Korr IM (ed). The Neurobiological Mechanisms in Manipulative Therapy. New York, Plenum Press, 1978;466pps
19. Patterson MM. A model mechanism for spinal segmental facilitation. JAOA 1976;76(1):62-72.
20. Pickar JG. Neurophysiological effects of spinal manipulation. Spine J. 2002 Sep-Oct;2(5):357-71.
21. Colloca CJ, Gunzburg R, Freeman BJ, Szpalski M, Afifi M, Moore RJ. Biomechanical quatification of pathological manipulatable spinal lesions: an invivo ovine model of spondylolysis and intervertebral disc degeneration. J Manipulative Physiol Ther, 2012;35(5):354-366.
22. Bakkum BW, Cramer GD, Henderson CNR, Hong S-P. Does subluxation affect the nervous system? Preliminary morphologic evidence that it does. J Chiropr Educ 2006;20:1-2.
23. Terrett A. The search for the subluxation: an investigation of medical literature to 1985. Chiropr Hist 1987;7(1):29-33.
24. Warbasse JP. Subluxation of vertebrae. In Surgical Treatment. A practical Treatise on the Therapy of Surgical Diseases for the Use of Practitioners and Students of Surgery. Vol 1. Philadelphia: WB Saunders Co; 1918.
25. Williams PL, Warwick R. Gray’s Anatomy 36th edn. New York: Churchill Livingstone; 1980;477.
26. Keats TE, Anderson MW. Atlas of normal roentgen variants that may simulate disease. 7th edn. St Louis: Mosby Inc. 2001.
27. Tassell L. President’s Report. The Aust Chiropr. 2013;1:3,17.
28. The Third Court of Appeals of Texas issued a 58-page opinion in Cause No. 03-10-673-CV – the Texas Board of Chiropractic Examiners (TBCE) and the Texas Chiropractic Association (TCA) vs. the Texas Medical Association (TMA), the Texas Medical Board (TMB) and the State of Texas. April 5, 2012. Cited by Edwards, J. The subluxation complex saves diagnosis in Texas. Dynamic Chiropr 2012;30(12): www.dynamicchiropractic.com
29. Adams CBT, Logue V. Studies in cervical spondylotic myelopathy. II The movement and contour of the spine in relation to the neural complications of cervical spondylosis. Brain 1971;94:569-586.
30. Adams CBT, Logue V. Studies in cervical spondylotic myelopathy. I. Movement of the cervical roots, dura and cords, and their relation to the course of their extrathecal roots. Brain, 1971;94:557-564.
31. Eder M, Tilscher H. Chirotherapie. Hippokrates Verlag, Stuttgart 1988. (Chiropractic therapy: Diagnosis and treatment.. Translated by Gengenbach MS, Aspen Publisher 1990. (Chapman-Smith Report July 1990)
32. Mirza SK, White AA, Panjabi MM. Evaluating instability in cervical spine injuries. Part 1: The occipital-cervical junction. J Musculoskel Med. 1996;13(3):59078.
33. Buchanan TS, Lloyd DG, Manal K, Besier TF. Neuromusculoskeletal modelling: estimation of muscle forces and joint moments and movements from measurements of neural command. J Appl Biomech. 204;20(4):367-395.
34. Dalgleish PH. Ortho-spondylo-dysathrics manipulation and the forgotten spinal joints. Rheumatism 1960;16:98-109.
35. Dulhunty J. Personal communication, (Email). June 13th 2005.
36. World Health Organisation’s publication, World Classification of Diseases (ICD-10) Chapter X111, 2006. http://www3.who.int/icd/currentversion/fr-icd.htm.
37. ICD-10. World Health Organisation. http://www.who.int/classifations/apps/icd/icd10online/
38. Churchill's Illustrated Medical Dictionary. Churchill Livingstone, New York. 1989.
39. Rome PL. Neurovertebral influence upon the autonomic nervous system: Some of the Somato-Autonomic Evidence To Date. Part I. Chiropr J Aust 2009;39(1):2-17.
40. Cramer GD, Barby SA. Basic and clinical anatomy of the spine, spinal cord and ANS. St Louis: Mosby;1995:251-372.
41. Gatterman MI. Subluxation – historical perspective. Chiropr J Aust. 2009;39(4):151-164.
42. Rome PL. Neurovertebral influence on visceral and ANS function: Some of the Somatovisceral Evidence To Date - Part II Somatovisceral. Chiropr J Aust. 2010;40(1):9-33.
43. Campo R. “Anecdotal evidence”: why narratives matter in medical practice. PloS Medicine. 2006;3:1677-1678.
44. Burns L, Chandler LC, Rice RW. Pathogenesis of visceral disease following vertebral lesions. .Am Osteop Assoc, Chicago 1948.
45. Bogen, Jim, "Theory and Observation in Science", The Stanford Encyclopedia of Philosophy (Spring 2013 Edition), Edward N. Zalta (ed.), URL = .
46. Carrick FR. Changes in brain function after manipulation of the cervical spine. J Manipulative Physiol Ther 1997;20(8):529-545.
47. Fraser DM. T3 Syndrome. In: Paterson JK, Burns L, editors. Back Pain - an international review. Dordrecht: Kluwer Academic, 1990;387-390.
48. McGuckin N. The T4 Syndrome. In: Grieve GP, ed. Modern manual therapy of the vertebral column. New York: Churchill Livingstone, 1986;370-376.
49. DeFranca GG, Levine LJ. The T4 Syndrome. J Manipulative Physiol Ther 1995;18(1):34-37.
50. Lujan HL, Janbaih H, DiCarlo SE. Dynamic interaction between the heart and its sympathetic innervation following T5 spinal cord transection. J Appl Physiol. 2012;113(8):1332-1341. doi: 10.1152/japplphysiol.00522.2012.
51. Hamberg J, Lindall O. Angina pectoris symptoms caused by thoracic spine disorders. Acta Med Scand Suppl 1981;644:84-86.
52. Rome PL. Anterior T6 subluxation syndrome: neurospinal dysfunction within a vertebral subluxation complex. Chiropr J Aust 2000;30(4):127-137.
53. Walters G. The real great escape. London: Bantam Press, 2013;3.
54. Peters R. Subluxation: Historical perspective. Chiropr J Aust. 2009;39(4):143-150.
55. Ebrall P. Towards better teaching about the vertebral subluxation complex. Chiropr J Aust. 2009;39(4):165-170.
56. Wenban AB. Subluxation research: a survey of peer-reviewed chiropractic scientific journals. Chiropr J Aust 2003;33(4):122-130