Advanced Biostructural Correction

jacky

Advanced Biostructural CorrectionAllen Botnick, D.C., B.A.Advanced BioStructural Correction™ (ABC™), also called Advanced Biostructural Therapy™ (ABT™), is a "subluxation"-based system that uses postural analyses to determine the patient's alleged problems. It was developed by Jesse J. Jutkowitz, D.C., a chiropractor whose license was revoked in 1996 and who now teaches his ideas through "at-home seminars." This article is based on an analysis of his promotional materials and my experience in working for him for a few months in 1998.
ABC is centered around the idea that poor posture, caused by anterior displacement (subluxation) of vertebrae, causes compensatory misalignments that predispose the spinal cord to injury from excessive stretching of the meninges (the membrane that surrounds the brain and spinal cord). Jutkowitz claims that vertebrae that get displaced forward get stuck because there is no muscle to pull them back and that other vertebrae compensate for this by twisting. Jutkowitz describes this as "the major problem in the human body" and claims to relieve the problem by "unlocking the meninges." [1] His introductory video likens the meninges to a twisted rubber band which compresses the spine, preventing chiropractic adjustments from realigning it [1].
Jutkowitz claims that ABC is the most effective system of diagnosing and treating structural (biomechanical) problems of the spine ever devised [2]. According to him, his method is "consistent and predictably effective" and can precisely diagnose patients through either special physical examination procedures or by comparing measurements of sitting and standing full-spine x-rays [3]. He claims his system alleviates musculoskeletal, neurological, and organic pathologies through "applying spinal cord relaxation." Although he claims that his theories are supported by the work of a Swedish neurosurgeon named Alf Breig, critics believe that he has misinterpreted or misrepresented Breig's findings [4].
Jutkowitz has marketed his approach in chiropractic trade publications, a web site, and solicitations on chiropractic discussion forums. For $699, chiropractors can obtain a home-study kit that includes audiotapes, manuals, videotapes, and telephone consultations. A second kit, available for $299, provides audiotapes and photographs of patient x-rays which illustrate the x-ray analysis upon which the system is based. His Web site also states that 800 doctors are using his methods.
The conditions that ABC is claimed to relieve or cure include amyotropic lateral sclerosis, asthma, cerebral palsies, carpal tunnel syndrome, cervical myelopathies, deafness, elbow problems, fibromyalgia, heart disease, knee problems, low back pain, multiple sclerosis, muscular dystrophy, neck pain, post-traumatic myelopathies, rhizopathies, trigeminal neuralgias, and urinary incontinence [2-3]. However, no research has validated these claims, and published research shows that the sitting x-ray views upon which his system is based are unreliable [5-8]. The meningeal release procedures do not make biomechanical sense because they are performed with the patient seated upright or with the patient's chest in extension, positions that relax the spinal cord. These procedures appear to be mere lateral flexion manipulations of upper cervical spine. There is no long-term evidence that the treatment can improve posture. Because of this, repeat treatments to accomplish what he calls "unwinding" of the spinal cord are unwarranted.
Because ionizing radiation is potentially harmful, responsible practitioners restrict the use of diagnostic x-rays to situations where the potential benefit outweighs the likelihood of harm. Full-spine x-rays expose the patient's sexual organs to a large amount of radiation while offering little or no useful information. Jutkowitz's videotape states that he subjected patients to four full-spine sitting and standing x-rays every 2-6 weeks while developing this method [1]. Criticized for excessive use, he now states that his methods have been sufficiently researched that treatment can be administered without doing x-ray examinations [9]. However, he continues to sell instructional materials for his x-ray analysis.
Disciplinary HistoryJutkowitz himself has been disciplined four times by Connecticut's chiropractic licensing board. In 1987, the board fined him $5,000, suspended his license for one year to be followed by three years of probation Public documents in the case indicate that during at least five visits he had inappropriately inserted his fingers into a female patient's rectum to administer a "coccygeal-meningeal procedure" that he said would cure her of acne and migraine headaches. Later the woman's husband sought treatment and was advised to have the same procedure and told that his health would suffer if he did not receive it. The board concluded that the woman's treatment was inappropriate and that Jutkowitz had taken too many x-rays. It also ruled that Jutkowitz's treatment of a man with scoliosis was "incompetent." [10]. Jutkowitz appealed through the courts, which upheld the board's decision, but the process delayed implementation of the board's order until 1991 [11].
In 1990, the board fined Jutkowitz $3,000, suspended his license for one year to be followed by three years of probation for engaging in "negligent or incompetent practice." The board's decision was based on two cases in which Jutkowitz had inserted his fingers into the rectum to "adjust" the patient's coccyx (tailbone). Neither patient had complained of tailbone discomfort; and Jutkowitz's management of the second woman included five full-spine x-rays over a 15-month period and lack of adequate records to show the patient's progress as of each visit. The board concluded that "no coccygeal adjustment of any kind was clinically substantiated" and that it was not medically necessary to x-ray the second patient five times [12]. Jutkowitz appealed and lost, but the suspension did not become became effective until after the appeals process ended in 1995 [11].
In 1993, the board fined Jutkowitz $2,000 and suspended his license for one year for "incompetent and negligent conduct." The board concluded that Jutkowitz had improperly managed a patient and taken too many x-rays on the day the patient consulted him. It appears from the records that the patient had carpal tunnel syndrome (a wrist problem) but Jutkowitz diagnosed a neck problem without taking a proper medical history or examining the man's arms [13]. Jutkowitz appealed through the courts, which upheld the board's decision in 1996, but by that time the board had voted to revoke his license [11].
In 1996, after hearing evidence that Jutkowitz had continued to examine and treat patients, the board revoked his license [14]. This time he could not get the revocation delayed, and his appeal was dismissed in January 1997 [11].
Following the revocation, Jutkowitz opened an office in California, which had licensed him in 1992. In March 1998, I accepted a job in his office, which was in Los Angeles. Although I knew that his Connecticut license had been revoked and that he was a Scientologist, I had found his articles interesting and thought he had come up with a genuine advance in chiropractic methodology. I personally observed him treat patients in his clinic, which was next to a Scientology headquarters where he attended classes. One day I became alarmed when he promised to cure a man of multiple sclerosis, a promise he could not possibly keep. Not long afterward, I resigned and informed the California Board of Chiropractic about this and his de-licensing in Connecticut. It turned out that he had violated California law by not notifying the board that his Connecticut license has been revoked. On July 2, 1998, the board ordered his license to be revoked as of August 1, 1998 [15].
Following the loss of his California license, Dr. Jutkowitz taught postgraduate license-renewal courses to chiropractors in California through the Logan College of Chiropractic.Without a current license, Jutkowitz was not actually eligible to teach postgraduate courses. In March 2001, Ralph Barrale, Logan's director of postgraduate education, told me Jutkowitz had not disclosed his license revocations when he had applied for approval of his course, but that the school no longer had a relationship with him and anticipated none in the future [16].
References

• Jutkowitz J. Advanced BioStructural Therapy Intro Tape. Videotape, distributed 2000.
• Jutkowitz, J. Chiropractic and other biostructural therapies can actually work as they are supposed to and help every patient truly get well. Undated reprint distributed in September 2000.
• Jutkowitz J. Standing and sitting full-spine x-ray analysis primer—A first look at what's been missing in full spine analysis of spinal biomechanics. Undated reprint distributed in September 2000.
• Ward RW. The research of Alf Breig: Setting the record straight. Dynamic Chiropractic 15(13):21, 1997.
• Black KM and others. The influence of different sitting positions on cervical and lumbar posture. Spine 21:65-70, 1996.
• Majeske C, Buchanan C. Quantitative description of two sitting postures. With and without a lumbar support pillow. Physical Therapy Oct:1531-1535, 1984.
• Bendix T. Hagberg M. Trunk posture and load on the trapezius muscle while sitting at sloping desks. Ergonomics 27:873-882, 1984.
• Bendix T, Biering-Sorensen F. Posture of the trunk when sitting on forward inclining seats. Scandinavian Journal of Rehabilitation Medicine 15:197-203, 1983.
• Jutkowitz J. X-rays not needed. ABC Web site, accessed March 7, 2003.
• Memorandum of decision. Connecticut State Board of Chiropractic Examiners, Petition No .831102-07-010, July 23, 1987.
• Codero J. E-mail to Allen Botnick, Feb 20, 2001.
• Memorandum of decision. State of Connecticut Board of Chiropractic Examiners, Petition No. #890103-07-001, p. June 17, 1993.
• Memorandum of decision. State of Connecticut Board of Chiropractic Examiners, Case No. 85072607-07-006, March 28, 1990.
• Memorandum of decision. State of Connecticut Department of Public Health, Petition No. 950505-07-011
• Default decision and order. In the matter of the accusation against Jesse Jacob Jutkowitz, D.C. Board of Chiropractic Examiners, State of California. No 98-31
• Barrale R. E-mail to Allen Botnick, D.C., March 5, 2001.
  

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Dr. Botnick, who operates Chirotalk Forum, is active in the fight against quackery.

This article was posted on March 7, 2003.

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