5 Reasons Why Scoliosis X-Rays Are Not Harmful

Abstract

Radiographic imaging for scoliosis screening, diagnosis, treatment, and management is the gold standard assessment tool. Scoliosis patients receive many repeat radiographs, typically 10-25 and as many as 40-50, equating to a maximum 50 mGy of cumulative exposure. It is argued this amount of radiation exposure is not carcinogenic to scoliosis patients for 5 main reasons: 1. Estimated theoretical cumulative effective doses remain below the carcinogenic dose threshold; 2. Scoliosis patient x-rays are delivered in serial exposures and therefore, mitigate any potential cumulative effect; 3. Linear no-threshold cancer risk estimates from scoliosis patient cohorts are flawed due to faulty science; 4. Standardized incidence/mortality ratios demonstrating increased cancers from aged scoliosis cohorts are confounded by the effects of the disease entity itself making it impossible to claim cause and effect resulting from low-dose radiation exposures from spinal imaging; 5. Children are not more susceptible to radiation damage than adults. Radiophobia concerns from patients, parents, and doctors over repeat imaging for scoliosis treatment and management is not justified; it adds unnecessary anxiety to the patient (and their parents) and interferes with optimal medical management. X-rays taken in the evidence-based management of scoliosis should be taken without hesitation or concern about negligible radiation exposures.

X-ray Hesitancy—Response to Jargin and Sohrabi

“…Though we agree this is a common belief, as is presented in our article there is a lack of evidence clearly showing children as being highly radiosensitive to low-dose exposures. Although we 4 and others 5 have provided more discussion elsewhere, it comes down to the notion that “for low-dose exposures, even in children the adaptive repair systems overcompensate to prevent, repair, and remove any damage caused, and likely is much more efficient than in adults.” 4 …”

“…We celebrate with Sohrabi who reports that discussions held at a recent Joint American Nuclear Society and Health Physics Conference led to a consensus that the LNT was “unsupported by basic science and represents an overestimate of the risks of low-dose/rate.” 3 We have presented this narrative in several publications recently in the arena of risk assessment from X-ray exposures in the manual therapies. 1 , 4 , 12 - 17 Our article at hand 1 highlighted 3 main concerns fueling “X-ray hesitancy” stemming from the fear-mongering from outdated LNT ideology; namely that 1. All radiation is harmful; 2.…”

“…We also acknowledge the efforts Sohrabi has made to develop an innovative “Universal Radiation Protection System” (URPS), a model that integrates LNT, threshold and hormesis concepts. 18 Regarding the URPS, we believe, as discussed in recent articles, 1 , 4 that because of the stimulation and upregulation of the adaptive protection systems from low-dose radiation (X-rays), the inclusion of a total effective cumulative dose (TCD) from low-doses (that initiates an almost immediate self-repair of genetic damage leaving a “net zero” damage effect) will lead to erroneous dose inputs and the overestimation of risks.…”

Radiophobic Fear-Mongering, Misappropriation of Medical References and Dismissing Relevant Data Forms the False Stance for Advocating Against the Use of Routine and Repeat Radiography in Chiropractic and Manual Therapy

“…We and many others have recently provided details of why low-dose radiation exposures (<200 mGy), including those from X-rays and CT scans are not harmful. 13 - 16 , 26 - 31 , 36 - 48 The issue of ionizing radiation carcinogenicity is the main underpinning for all anti-imaging rhetoric. Here we sum up many of the arguments against LNT and related concepts that refute the presumptive notion that X-rays cause cancer.…”

“… 1 - 12 As well, there are indeed chiropractic guidelines 31 - 34 and rationale 13 - 16 , 35 that support routine imaging and, as we will discuss later, low-dose radiation exposures from X-rays are now known to be harmless based on updated information. 36 - 48 …”