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Disección de Arteria Cervical Diagnosticada Tras Manipulación Cervical Quiropráctica: Un Subanálisis del Registro
Rozaleen Aleyadeh1, Marialuisa Zedde2, Joao P Marto3
1Department of Neurology, The Warren Alpert Medical School of Brown University, Brown Medical School.
The neurologist
|January 20, 2026
Resumen
La disección de arterias cervicales (CeAD) es rara después de la manipulación quiropráctica, aunque los casos asociados son mujeres más jóvenes con disecciones vertebrales. El riesgo absoluto sigue siendo extremadamente bajo a pesar de millones de procedimientos anuales.
Área de la Ciencia:
- Neurología
- Medicina Vascular
- Salud Pública
Sus antecedentes:
- La disección de arterias cervicales (CeAD) es una causa importante de accidente cerebrovascular isquémico en adultos jóvenes.
- Millones de manipulaciones cervicales quiroprácticas ocurren anualmente en los EE. UU., con un vínculo controvertido con la CeAD.
Objetivo del estudio:
- Investigar la asociación entre la manipulación cervical quiropráctica y la CeAD.
- Identificar las características clínicas de la CeAD asociada a la manipulación.
Principales métodos:
- Análisis del registro multicéntrico STOP-CAD (n=4023) para casos de CeAD.
- Comparación de datos demográficos y características clínicas entre CeAD asociada a manipulación y no asociada a manipulación.
- Regresión logística multivariante para identificar factores asociados con la CeAD relacionada con la manipulación.
Principales resultados:
- Aproximadamente el 5% de los casos de CeAD en el registro informaron manipulación quiropráctica previa.
- La CeAD asociada a la manipulación ocurrió con mayor frecuencia en mujeres jóvenes, aquellas sin diabetes y con dolor de cuello.
- Se observaron mayores probabilidades de disección aislada de la arteria vertebral en casos asociados a manipulación.
Conclusiones:
- El riesgo absoluto de CeAD después de la manipulación quiropráctica es muy bajo, a pesar del alto volumen de procedimientos.
- Los casos de CeAD asociada a manipulación presentan características clínicas distintas, a menudo involucrando a mujeres jóvenes y arterias vertebrales.
- La relación causal sigue sin estar clara: manipulación como desencadenante o síntomas tempranos de CeAD que provocan la manipulación.
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