Neck Manipulation Linked to Cervical Dissection — Physician’s First Watch

Medical News |
August 8, 2014

Neck Manipulation Linked to Cervical Dissection

By Larry Husten

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

After a neck adjustment — also known as cervical manipulative therapy and typically employed by chiropractors and other healthcare providers — people are at increased risk for cervical dissections, which can lead to stroke, according to a scientific statement released by the American Heart Association and American Stroke Association.

Current knowledge about cervical dissection is limited to case-control studies and clinical reports, making it impossible to establish a cause-and-effect relationship. In some cases, an alternative explanation may be that patients in the early stage of cervical dissection may go to a chiropractor or other healthcare provider for relief of their neck pain. Nonetheless, the statement advises healthcare providers to tell their patients about the association before starting the procedure.

In an AHA press release, the study's lead author said, "Although a cause-and-effect relationship between these therapies and [cervical dissection] has not been established and the risk is probably low, [cervical dissection] can result in serious neurological injury."

Reader Comments (7)

PEPI GRANAT Physician, Family Medicine/General Practice, Pepi Granat, MD solo office

You might like to read my article, "Chiropractic Caveats". Nothing has changed since it was written some time ago. Several instances of the reported sequela are referenced.
Pepi Granat, MD
Title: The Journal of the Florida Medical Association
Title Abbrev: J Fla Med Assoc
Citation: 1990 Aug;77(B):727-7
Article: Chiropractic caveats,
Author: Granat P
NLM Unique ID: 7505604 Verify: PubMed
PubMed UI: 2254735
ISSN: 0015-4148 (Print)
Fill from: Any format
Publisher: Florida Medical Association, Jacksonville, FL :
Copyright: Copyright Compliance Guidelines

John Murphy Other Healthcare Professional, Other

Here is the real information you asked for, Tina McLeod. My father had his neck broken by a chiropractor when he was 49. His life was never the same after. It took him ten miserable years to die from a stroke.

Elizabeth Daw Other Healthcare Professional, Rheumatology, Multi- disciplinary clinic

Past studies have revealed damage to the intimal wall of vesicles can occur post extremity cast removal and renewed mobility. Hence anti-coagulant therapies helped to prevent the complication of blood clots. Less casting and early mobility diminishes this complication but the same can occur when a chiropractor performs a sudden forceful twist to the vertebral arteries etc causing damage to the vesicle walls. If they came from a real faculty of medicine then they might know this.

Michael Venuto, BA, MA, Phd Other, Other, retired

"cause-and-effect" takes in a broad range of possibilities... in a clinical environment patients have diverse medical problems entering a clinic for medical help. Unless there is a through examination and review of each patient background prior to manipulation and following it becomes unlikely a diagnosis can be made.

Philip Levitt, MD Physician, Surgery, Specialized, home-retired

Over thirty years of neurosurgical practice I saw two cases in which the onset of an infarction in the posterior inferior cerebellar artery distribution--lateral medullary syndrome--was simultaneous with cervical chiropractic manipulation. The cause in both was occlusion of the vertebral artery. This was typical of the findings in six cases reported by Odom from Duke in the sixties.

Tina McLeod MS Other Healthcare Professional, Preventive Medicine

Shame on you! Where is the research! Cervical adjustments are perfectly safe as long as they are performed by skilled practioners - chiropractors. I am angry beyond belief that you would put an article out about this with no real information!

JERZY SIERAKOWSKI Physician, Family Medicine/General Practice, Germany

You're absolutly right! In 34 y. practice (Internal med. /General practice and chotherapy /osteopathy i've never seen such complications. Only once by a orthopedist.

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