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Related Experiment Videos

Vertebral artery damage complicating cervical manipulation.

A Fast1, D F Zinicola, E L Marin

  • 1Department of Physical Medicine and Rehabilitation, Nassau County Medical Center, East Meadow, New York.

Spine
|November 1, 1987
PubMed
Summary
This summary is machine-generated.

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Cervical manipulation can cause serious neurologic injury from vertebrobasilar trauma. Prompt diagnosis and anticoagulant therapy are crucial for managing brain stem ischemia following vertebral artery injury.

Area of Science:

  • Neurology
  • Vascular Surgery
  • Anatomy

Background:

  • Cervical manipulation is a common chiropractic and physical therapy technique.
  • The vertebrobasilar system, comprising the vertebral arteries and basilar artery, supplies blood to the brainstem and cerebellum.
  • Vertebral arteries are vulnerable to injury during cervical manipulation due to their anatomical course.

Observation:

  • The vertebral arteries are susceptible to trauma at the transverse foramina, atlantoaxial joint, and occipitoatlantal joint.
  • Asymmetrical sizes of the vertebral arteries increase the risk of brain stem ischemia if the larger artery is damaged.
  • Vertebral artery obstruction can occur even with normal ranges of motion during cervical manipulation, particularly with extension and rotation.

Findings:

Related Experiment Videos

  • Cervical manipulation poses a risk of serious neurologic injury due to vertebrobasilar system trauma.
  • Damage to the dominant vertebral artery can lead to critical brain stem ischemia.
  • Obstruction of vertebral arteries is a potential complication of cervical manipulation.

    • Implications:

    • Accurate and timely diagnosis of neurologic injury following cervical manipulation is essential.
    • Prompt initiation of anticoagulant therapy is critical for managing vertebral artery dissection and preventing ischemic events.
    • Awareness of these risks is important for healthcare providers performing or referring for cervical manipulation.