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Related Experiment Videos

Risks associated with spinal manipulation.

Clare Stevinson1, Edzard Ernst

  • 1Department of Complementary Medicine, School of Sport and Health Sciences, University of Exeter, Exeter, United Kingdom.

The American Journal of Medicine
|May 17, 2002
PubMed
Summary

Spinal manipulation can cause minor side effects in about half of patients. Serious risks like stroke and disk herniation are rare, occurring from 1 in 400,000 to 1 in 2 million procedures.

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Area of Science:

  • Chiropractic and Osteopathic Medicine
  • Neurology
  • Public Health

Background:

  • Spinal manipulation is a popular therapy.
  • Understanding its associated risks is crucial for patient safety.

Purpose of the Study:

  • To systematically review and summarize the evidence on the risks of spinal manipulation.

Main Methods:

  • Comprehensive literature search of multiple databases (MEDLINE, EMBASE, Cochrane Library).
  • Inclusion of reports in any language, regardless of therapist profession.
  • Independent evaluation of all papers by authors, prioritizing systematic reviews.

Main Results:

  • Minor, transient adverse events are common, affecting approximately 50% of patients.
  • Serious adverse events include vertebrobasilar accidents, disk herniation, and cauda equina syndrome.
  • Incidence of serious complications estimated between 1 in 400,000 and 1 in 2 million manipulations.

Conclusions:

  • Spinal manipulation is associated with a high incidence of minor adverse events.
  • Serious complications, though rare, are significant and necessitate further safety investigations.
  • The widespread use of spinal manipulation warrants continued rigorous safety research.

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