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[Is systematic radiography needed before spinal manipulation? Recommendations of the SOFMMOO]
J-Y Maigne1, J-C Goussard, F Dumont
1Service de médecine physique, Hôtel-Dieu de Paris, 1, place du Parvis de Notre-Dame, 75181 Paris cedex 04, France. jy.maigne@htd.aphp.fr
Systematic radiography before cervical manipulation is recommended, especially for patients under 25 with back or neck pain. For other spinal manipulations, existing guidelines are generally sufficient, with an exception for aneurysmal bone cysts.
Area of Science:
- Medical Imaging
- Spinal Manipulation
- Radiology
Background:
- French National Health Authority guidelines suggest pre-manipulation radiography.
- Current research indicates potential disadvantages of routine radiography.
- Complications following cervical manipulation are a concern when prior radiography is absent.
Purpose of the Study:
- To review literature on spinal manipulation complications.
- To determine if preliminary radiography could have prevented complications.
- To assess if international guidelines adequately address these complications.
Main Methods:
- Comprehensive literature search.
Main Results:
- International guidelines suffice for lumbar/thoracic spine, barring aneurysmal bone cysts (up to age 25).
- Cervical spine manipulation: Prudence and medicolegal factors support routine radiography.
- Lack of data for cervical spine complications necessitates a cautious approach.
Conclusions:
- SOFMMOO recommends pre-cervical manipulation radiography.
- Radiography is advised for patients under 25 with neck/back pain.
- International guidelines are adequate for most other spinal manipulation cases.
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