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[Cervical spine manipulation: risks--benefit--assessment].

Ph Vautravers¹, J-Y Maigne

¹Service de Médecine Physique et de Réadaptation, Hôpital de Hautepierre, Strasbourg.

Revue Neurologique

|January 8, 2004

Summary

Cervical manipulation for neck pain and headaches carries rare risks of severe neurologic complications. Following five consensus recommendations can help minimize these potential adverse events.

Area of Science:

Neurology
Orthopedics
Physical Medicine

Context:

Cervical manipulation is a common treatment for non-specific mechanical neck pain and cervicogenic headaches.
While generally safe, severe neurologic complications, though rare, can occur.
These risks are comparable to those associated with other treatments like nonsteroidal anti-inflammatory drugs.

Purpose:

To propose evidence-based recommendations for minimizing the risks associated with cervical manipulation.
To enhance patient safety during chiropractic and osteopathic manipulative treatments.
To provide guidance for healthcare professionals performing cervical manipulation.

Summary:

Five consensus recommendations are presented to reduce the risk of severe neurologic complications from cervical manipulation.

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Key recommendations include assessing prior adverse effects, conducting thorough pre-manipulation physical and neurological examinations, adhering to indications/contraindications, ensuring experienced practitioners, and obtaining informed consent with clear risk disclosure.

Routine inquiry into minor adverse effects like nausea or vertigo should contraindicate future manipulations.

Impact:

Implementing these recommendations can significantly improve patient safety in cervical manipulation procedures.
This guidance aims to reduce the incidence of rare but severe neurological adverse events.
Promoting safer practices in manual therapy for neck pain and headache management.