Acute paraplegia following chiropractic therapy
Che-Chuan Wang1, Jinn-Rung Kuo, Chung-Ching Chio
1Department of Neurosurgery, Chi-Mei Medical Center, 901 Chung Hwa Road, Yung Kang City, Tainan 710, Taiwan.
Summary
A delayed diagnosis of spinal epidural abscess following chiropractic therapy led to paraplegia. Prompt MRI and surgery are crucial for managing spinal infections and preventing paralysis.
Area of Science:
- Neurology
- Infectious Diseases
- Neurosurgery
Background:
- Spinal epidural abscesses (SEAs) can cause severe neurological deficits.
- Chiropractic manipulation, while often beneficial, carries a rare risk of complications.
Observation:
- A 44-year-old male presented with complete paraplegia after chiropractic therapy for back pain.
- Diagnosis of a paraspinal and epidural abscess was significantly delayed.
Findings:
- Immediate T3-T6 laminectomy and 4-week antibiotic therapy (Staphylococcus aureus) were administered.
- After rehabilitation, the patient regained bladder function but had persistent lower extremity paresis.
Implications:
- Urgent spinal gadolinium-enhanced MRI is vital for patients with back pain and elevated inflammatory markers.
- Awareness of potential paraplegia risk after forceful back massage is essential for clinicians and patients.