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Is cervical spinal manipulation dangerous?
Peter B Licht1, Henrik W Christensen, Poul F Høilund-Carlsen
1Department of Clinical Physiology and Nuclear Medicine, Odense University Hospital, DK-5000 Odense, Denmark. peter.licht@sks.aaa.dk
Journal of Manipulative and Physiological Therapeutics
|January 18, 2003
Summary
Cervical manipulation for neck pain can cause cerebrovascular infarction, but recovery is possible. This case study suggests the risk of serious complications from this treatment is low.
Area of Science:
- Neurology
- Vascular Medicine
- Physical Medicine and Rehabilitation
Background:
- Cervical manipulation is a common treatment for neck pain.
- Concerns exist regarding potential cerebrovascular accidents (CVAs) following cervical manipulation.
Observation:
- A 39-year-old male experienced immediate severe headache and neurological symptoms after cervical manipulation for nonspecific neck pain.
- Cerebral infarction was confirmed via imaging, specifically affecting the left cerebellar hemisphere.
Findings:
- Neurological symptoms resolved completely within 3 months.
- Despite persistent imaging evidence of cerebellar infarction, the patient remained asymptomatic at a 7-year follow-up.
- Cervical vessel imaging revealed patent vertebral arteries, with no abnormalities detected.
Implications:
- The risk of CVAs after cervical manipulation appears low, especially compared to surgical interventions.
- Cervical manipulation may be considered acceptably low-risk when indicated, with fears of severe complications potentially exaggerated.
- This case highlights the possibility of significant recovery from cerebrovascular events post-manipulation.