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A missed Jefferson fracture in chiropractic practice
1rregelink@wxs.nl
Journal of Manipulative and Physiological Therapeutics
|April 21, 2001
Summary
A missed cervical spine fracture diagnosis highlights the importance of chiropractor vigilance. Chiropractors should always evaluate patient radiographs, as hospital reports may not always be definitive for manipulative treatment contraindications.
Area of Science:
- Chiropractic care
- Radiographic interpretation
- Spinal trauma
Background:
- Neck pain is a common complaint following trauma.
- Cervical spine fractures can be subtle and easily missed on initial radiographic review.
- Accurate diagnosis is crucial before initiating manipulative therapy.
Observation:
- A 21-year-old male sustained a fall from height, presenting with neck pain.
- Initial hospital radiographs were interpreted as normal.
- A chiropractor suspected a Jefferson fracture of the atlas upon reviewing the same radiographs.
Findings:
- The chiropractor confirmed the atlas fracture by retaking an anteroposterior open-mouth radiograph.
- The patient received prompt neurosurgical treatment following referral.
- Successful recovery was achieved after appropriate intervention.
Implications:
- Relying solely on initial radiographic reports can be risky, especially when considering manipulative treatments.
- Chiropractors must exercise critical evaluation of all provided imaging.
- Independent radiographic assessment by chiropractors is vital for patient safety and effective care.