Vertebrobasilar injuries following cervical manipulation

Area of Science:

• Neurology
• Vascular Surgery
• Physical Medicine

Background:

• Cervical manipulation is a common chiropractic therapy.
• Vertebrobasilar injuries are a known complication.
• Increasing use of chiropractic therapy necessitates awareness of risks.

Observation:

• Four cases of brainstem stroke syndromes were reported following mechanical cervical manipulation.
• Vascular injury, specifically to the vertebrobasilar system, was confirmed via angiography.
• The neurological complications can be severe.

Findings:

• Mechanical cervical manipulation can lead to vertebrobasilar artery dissection and stroke.
• Mechanisms of injury include excessive neck extension and rotation.
• Pathogenesis involves intimal injury and thrombus formation.

Implications:

• Healthcare providers should be aware of the potential for serious neurological injury from cervical manipulation.
• Patients should be informed about the risks associated with chiropractic therapy.
• Further research is needed to establish safer manipulation techniques and patient selection criteria.