Safety of cervical spine manipulation: Are adverse events preventable and are manipulations being performed appropriately? A review of 134 case reports

Journal of Manual and Manipulative Therapy

Volumn 20, Issue 2, 2012, Pages 66-74

  Puentedura, Emilio J ^a   March, Jessica ^a   Anders, Joe ^a   Perez, Amber ^a   Landers, Merrill R ^a   Wallmann, Harvey W ^b   Cleland, Joshua A ^c  

^a UNIVERSITY OF NEVADA   (United States)

^b WESTERN KENTUCKY UNIVERSITY   (United States)

^c FRANKLIN PIERCE UNIVERSITY   (United States)

Author keywords

Adverse events; Case reports; Cervical spine; Manipulation; Risk of harm; Safety

Indexed keywords

AGE; ARTERY DISSECTION; BLURRED VISION; CERVICAL SPINE; CERVICAL SPINE MANIPULATION; CHIROPRACTOR; CONSERVATIVE TREATMENT; DEATH; DIAGNOSTIC REASONING; DIZZINESS; DYSARTHRIA; DYSPHAGIA; GENDER; HUMAN; INTERVENTION STUDY; MANIPULATIVE MEDICINE; MUSCLE WEAKNESS; NAUSEA; PAIN; PARESTHESIA; PHYSICAL EXAMINATION; PHYSICIAN; PHYSIOTHERAPY; RETROSPECTIVE STUDY; REVIEW; RISK; SPINE DISEASE; SYMPTOM; TINNITUS; TREATMENT CONTRAINDICATION; VERTIGO; VISUAL DISORDER;

EID: 84861871147     PISSN: 10669817     EISSN: 20426186     Source Type: Journal    
DOI: 10.1179/2042618611Y.0000000022     Document Type: Review

References (121)

1. Refshauge K., Parry S, Shirley D, Larsen D, Rivett DA, Boland R. Professional responsibility in relation to cervical spine manipulation. Aust J Physiother. 2002;48:171-9.
2. Rivett DA. Adverse events and the vertebral artery: can they be averted? Man Ther. 2006;11:241-2.
3. Puentedura EJ, Landers MR, Cleland JA, Mintken PE, Huijbregts P, Fernandez-de-Las-Penas C. Thoracic spine thrust manipulation versus cervical spine thrust manipulation in patients with acute neck pain: a randomized clinical trial. J Orthop Sports Phys Ther. 2011;41:208-20.
4. Carnes D, Mullinger B, Underwood M. Defining adverse events in manual therapies: a modified Delphi consensus study. Man Ther. 2010;15:2-6.
5. Magarey ME, Rebbeck T, Coughlan B, Grimmer K, Rivett DA, Refshauge K. Pre-manipulative testing of the cervical spine review, revision and new clinical guidelines. Man Ther. 2004;9:95-108.
6. Haldeman S, Carey P, Townsend M, Papadopoulos C. Arterial dissections following cervical manipulation: the chiropractic experience. CMAJ. 2001;165:905-6.
7. Di Fabio RP. Manipulation of the cervical spine: risks and benefits. Phys Ther. 1999;79:50-65.
8. Ernst E. Manipulation of the cervical spine: a systematic review of case reports of serious adverse events, 1995-2001. Med J Aust. 2002;176:376-80.
9. Ernst E. Adverse effects of spinal manipulation: a systematic review. J R Soc Med. 2007;100:330-8.
10. Haldeman S, Kohlbeck FJ, McGregor M. Unpredictability of cerebrovascular ischemia associated with cervical spine manipulation therapy: a review of sixty-four cases after cervical spine manipulation. Spine (Phila Pa 1976). 2002; 27:49-55.
11. Childs JD, Flynn TW, Fritz JM, Piva SR, Whitman JM, Wainner RS, et al. Screening for vertebrobasilar insufficiency in patients with neck pain: manual therapy decision-making in the presence of uncertainty. J Orthop Sports Phys Ther. 2005;35:300-6.
12. Coulter ID, Hurwitz EL, Adams AH, Meeker WC, Hansen DT, Mootz RD, et al. The appropriateness of spinal manipulation and mobilization of the cervical spine. Santa Monica, CA: Rand Publishing; 1996.
13. Shekelle PG, Hurwitz EL, Coulter I, Adams AH, Genovese B, Brook RH. The appropriateness of chiropractic spinal manipulation for low back pain: a pilot study. J Manipulative Physiol Ther. 1995;18:265-70.
14. Terrett AG. Vascular accidents from cervical spine manipulation: report on 107 cases. J Aust Chiropr Assoc. 1987;17:15-24.
15. Beatty RA. Dissecting hematoma of the internal carotid artery following chiropratic cervical manipulation. J Trauma. 1977; 17:248-9.
16. Braun IF, Pinto RS, De Filipp GJ, Lieberman A, Pasternack P, Zimmerman RD. Brain stem infarction due to chiropractic manipulation of the cervical spine. South Med J. 1983;76:1507-10.
17. Braune HJ, Munk MH, Huffmann G. Cerebral infarct in the circulatory area of the arteria cerebri media following chiropractic therapy of the cervical spine. Dtsch Med Wochenschr. 1991;116:1047-50.
18. Brownson RJ, Zollinger WK, Madeira T, Fell D. Sudden sensorineural hearing loss following manipulation of the cervical snine. Laryngoscope. 1986-96:166-70.
19. Cellerier P, Georget AM. Dissection of the vertebral arteries after manipulation of the cervical spine. Apropos of a case. J Radiol. 1984;65:191-6.
20. Chen WL, Chern CH, Wu Y., Lee CH. Vertebral artery dissection and cerebellar infarction following chiropractic manipulation. Emerg Med J. 2006;23:el.
21. Chung OM. MRI confirmed cervical cord injury caused by spinal manipulation in a Chinese patient. Spinal Cord. 2002; 40:196-9.
22. Cook JW, 4th, Sanstead JK. Wallenberg's syndrome following self-induced manipulation. Neurology. 1991:41:1695-6.
23. Devereaux MW. The neuro-ophthalmologic complications of cervical manipulation. J Neuroophthalmol. 2000;20:236-9.
24. Domenicucci M, Ramieri A, Salvati M, Brogna C, Raco A. Cervicothoracic epidural hematoma after chiropractic spinal manipulation therapy. Case report and review of the literature. J Neurosurg Spine. 2007;7:571-4.
25. Donovan JS, Kerber CW, Donovan WH, Marshall LF. Development of spontaneous intracranial hypotension concurrent with grade IV mobilization of the cervical and thoracic spine: a case report. Arch Phys Med Rehabil. 2007:88:1472-3.
26. Dunne JW, Conacher GN, Khangure M, Harper CG. Dissecting aneurysms of the vertebral arteries following cervical manipulation: a case report. J Neurol Neurosurg Psychiatry. 1987;50:349-53.
27. Ea HK, Weber AJ, Yon F, Liote F. Osteoporotic fracture of the dens revealed by cervical manipulation. Joint Bone Spine. 2004:71:246-50.
28. Easton JD, Sherman DG. Cervical manipulation and stroke. Stroke. 1977;8:594-7.
29. Frisoni GB, Anzola GP. Vertebrobasilar ischemia after neck motion. Stroke 1991;22: 1452-60
30. Fritz VU, Maloon A, Tuch P. Neck manipulation causing stroke. Case reports. S Afr Med J. 1984;66:844-6.
31. Frumkin LR, Baloh RW. Wallenberg's syndrome following neck manipulation. Neurology. 1990;40:611-5.
32. Gittinger JW, Jr. Occipital infarction following chiropractic cervical manipulation. J Clin Neuroophthahnol. 1986;6:11-3.
33. Gouveia LO, Castanho P, Ferreira JJ, Guedes MM, Falcao F, e Melo TP. Chiropractic manipulation: reasons for concern? Clin Neurnl Neurosurg 2007;109:922-5
34. Grayson M. Horner's syndrome after manipulation of the neck. BMJ. 1987;295:1381-2.
35. Heffner JE. Diaphragmatic paralysis following chiropractic manipulation of the cervical spine. Arch Intern Med. 1985; 145:562-4.
36. Heiner JD. Cervical epidural hematoma after chiropractic spinal manipulation. Am J Emerg Med. 2009;27:1023.e1-2.
37. Hillier CE, Gross ML. Sudden onset vomiting and vertigo following chiropractic neck manipulation. Postgrad Med J. 1998;74:567-8.
38. Hinse P, Thie A, Lachenmayer L. Dissection of the extracranial vertebral artery: report of four cases and review of the literature. J Neurol Neurosurg Psychiatry. 1991;54:863-9
39. Hoffelner T, Maurer-Ertl W, Kienbacher G, Radl R, Leithner A, Windhager R. Internal jugular vein thrombosis following cervical manipulation. Man Ther. 2009;14:706-8.
40. Horn SW, 2nd. The 'locked-in' syndrome following chiropractic manipulation of the cervical spine. Ann Emerg Med. 1983:12:648-50.
41. Hsieh JH, Wu CT, Lee ST. Cervical intradural disc herniation after spinal manipulation therapy in a patient with ossification of posterior longitudinal ligament: a case report and review of the literature spine. (Phi1a Pa 1976) 2010;35:E149-51
42. Jay WM, Shah MI, Schneck MJ. Bilateral occipital-parietal hemorrhagic infarctions following chiropractic cervical manipulation. Semin Ophthalmol. 2003;18:205-9.
43. Jentzen JM, Amatuzio J, Peterson GF. Complications of cervical manipulation: a case report of fatal brainstem infarct with review of the mechanisms and predisposing factors. J Forensic Sci. 1987;32:1089-94.
44. Jeret JS, Bluth M. Stroke following chiropractic manipulation. Report of 3 cases and review of the literature. Cerebrovasc Dis. 2002:13:210-3.
45. Kanshepolsky J, Danielson H, Flynn RE. Vertebral artery insufficiency and cerebellar infarct due to manipulation of the neck. Report of a case. Bull Los Angeles Neurol Soc. 1972; 37:62-5.
46. Katirji MB, Reinmuth OM, Latchaw RE. Stroke due to vertebral artery iniury. Arch Neurol. 1985:42:242-8.
47. Khan AM, Ahmad N, Li X, Korsten MA, Rosman A. Chiropractic sympathectomy: carotid artery dissection with oculosympathetic palsy after chiropractic manipulation of the neck Mt Sinai J Med 2005;72:207-10
48. Kraft CN, Conrad R, Vahlensieck M, Perlick L, Schmitt O, Diedrich O. Non-cerebrovascular complication in chirotherapy manipulation of cervical vertebra. Z Orthop Ihre Grenzgeb. 2001;139:8-11.
49. Krieger D, Leibold M, Bruckmann H. Dissections of the vertebral artery following cervical chiropractic manipulations. Dtsch Med Wochenschr. 1990;115:580-3.
50. Krueger BR, Okazaki H. Vertebral-basilar distribution infarction following chiropractic cervical manipulation. Mayo Clin Proc 1980;55:322-32
51. Kunkle EC, Muller JC, Odom GL. Traumatic brain-stem thrombosis: report of a case and analysis of the mechanism of injury. Ann Intern Med. 1952;36:1329-35.
52. Kurbanyan K, Lessell S. Intracranial hypotension and abducens palsy following upper spinal manipulation. Br J Onhthalmol. 2008:92:153-5.
53. Lennington BR, Laster DW, Moody DM, Ball MR. Traumatic pseudoaneurysm of ascending cervical artery in neurofibromatosis: complication of chiropractic manipulation. AJNR Am J Neuroradiol. 1980;1:269-70.
54. Liao CC, Chen LR. Anterior and posterior fixation of a cervical fracture induced by chiropractic spinal manipulation in ankylosing spondylitis: a case report. J Trauma. 2007; 63:E90-4.
55. Lipper MH, Goldstein JH, Do HM. Brown-Sequard syndrome of the cervical spinal cord after chiropractic manipulation. AJNR Am J Neuroradiol. 1998;19:1349-52.
56. Ludwig SC, Vaccaro AR, Balderston RA, Cotler JM. Immediate quadriparesis after manipulation for bilateral cervical facet subluxation. A case report. J Bone Joint Surg Am. 1997;79:587-90.
57. Malone DG, Baldwin NG, Tomecek FJ, Boxell CM, Gaede SE, Covington CG, et al. Complications of cervical spine manipulation therapy: 5-year retrospective study in a singlegroun practice. Neurnsurg Focus. 2002; 13:ecpl.
58. Mas JL, Henin D, Bousser MG, Chain F, Hauw JJ. Dissecting aneurysm of the vertebral artery and cervical manipulation: a case report with autopsy. Neurology. 1989;39:512-5.
59. Mendel T, Baranska-Gieruszczak M. Brain stem syndrome after cervical chiropractic manipulations. Neurol Neurochir Pol. 2001:35:695-9.
60. Menendez-Gonzalez M, Garcia C, Suarez E, Fernandez-Diaz D, Blazquez-Menes B. Wallenberg's syndrome secondary to dissection of the vertebral artery caused by chiropractic manipulation. Rev Neurol. 2003;37:837-9.
61. Morelli N, Gallerini S, Gori S, Chiti A, Cosottini M, Orlandi G, et al. Intracranial hypotension syndrome following chiropractic manipulation of the cervical spine. J Headache Pain. 2006;7:211-3.
62. Mueller S, Sahs AL. Brain stem dysfunction related to cervical manipulation. Report of three cases. Neurology 1976;26(6 Pt 1):547-50.
63. Murphy DR. Herniated disc with radiculopathy following cervical manipulation: nonsurgical management. Spine J. 2006:6:459-63.
64. Murthy JM, Naidu KV. Aneurysm of the cervical internal carotid artery following chiropractic manipulation. J Neurol Neurosurg Psychiatry. 1988;51:1237-8.
65. Nadgir RN, Loevner LA, Ahmed T, Moonis G, Chalela J, Slawek K, et al. Simultaneous bilateral internal carotid and vertebral artery dissection following chiropractic manipulation: case report and review of the literature. Neuroradiology. 2003;45:311-4.
66. Nyberg-Hansen R, Loken AC, Tenstad O. Brainstem lesion with coma for five years following manipulation of the cervical spine. J Neurol. 1978;218:97-105.
67. Oehler J, Gandjour J, Fiebach J, Schwab S. Bilateral vertebral artery dissection after chiropractic treatment. Orthopade. 2003;32:911-3.
68. Oppenheim JS, Spitzer DE, Segal DH. Nonvascular complications following spinal manipulation. Spine J. 2005;5:660-6.
69. Padua L, Padua R, LoMonaco M, Tonali PA. Radiculomedullary complications of cervical spinal manipulation. Spinal Cord. 1996;34:488-92.
70. Panagariya A, Kumawat BL, Singh R, Sukhani P. Total unilateral medullary syndrome - a rare complication of chiropractic manipulation. J Assoc Physicians India. 2004; 52:556.
71. Parenti G, Orlandi G, Bianchi M, Renna M, Martini A, Murri L. Vertebral and carotid artery dissection following chiropractic cervical manipulation. Neurosurg Rev. 1999;22:127-9.
72. Parkin PJ, Wallis WE, Wilson JL. Vertebral artery occlusion following manipulation of the neck. N Z Med J. 1978;88:441-3.
73. Parwar BL, Fawzi AA, Arnold AC, Schwartz SD. Horner's syndrome and dissection of the internal carotid artery after chiropractic manipulation of the neck. Am J Ophthalmol. 2001;131:523-4.
74. Patel A, Lee R, Fritz W, Matos E, Freeman JW. Vertebral artery dissection from cervical spine manipulation: case renorts and analysis. dS D Med 2008;61:95, 7-9
75. Peters M, Bohl J, Thomke F, Kallen KJ, Mahlzahn K, Wandel E, et al. Dissection of the internal carotid artery after chiropractic manipulation of the neck. Neurology. 1995;45: 2284-6.
76. Phillips SJ, Maloney WJ, Gray J. Pure motor stroke due to vertebral artery dissection. Can J Neurol Sci. 1989;16:348-51.
77. Povlsen UJ, Kjaer L, Arlien-Soborg P. Locked-in syndrome following cervical manipulation. Acta Neurol Scand. 1987;76: 486-8.
78. Powell FC, Hanigan WC, Olivero WC. A risk/benefit analysis of spinal manipulation therapy for relief of lumbar or cervical pain. Neurosurgery. 1993;33:73-8.
79. Prasad S, El-Haddad G, Zhuang H, Khella S. Intracranial hypotension following chiropractic spinal manipulation. Headache. 2006:46:1456-8.
80. Pribek RA. Brain stem vascular accident following neck manipulation. Wis Med J. 1963;62:141-3.
81. Putnam TD, Wu Y. Tracheal rupture following cervical manipulation: late complication posttracheostomy. Arch Phys Med Rehabil. 1986;67:48-50.
82. Quintana JG, Drew EC, Richtsmeier TE, Davis LE. Vertebral artery dissection and stroke following neck manipulation by Native American healer. Neurology. 2002;58:1434-5.
83. Raskind R, North CM. Vertebral artery injuries following chiropractic cervical spine manipulation - case reports. Angiology 1990;41:445-52
84. Rinsky LA, Reynolds GG, Jameson RM, Hamilton RD. A cervical spinal cord injury following chiropractic manipulation. Paraplegia. 1976;13:223-7.
85. Schellhas KP, Latchaw RE, Wendling LR, Gold LH. Vertebrobasilar injuries following cervical manipulation. JAMA. 1980;244:1450-3.
86. Schmitz A, Lutterbey G, von Engelhardt L, von Falkenhausen M, Stoffel M. Pathological cervical fracture after spinal manipulation in a pregnant patient. J Manipulative Physiol Ther. 2005;28:633-6.
87. Schram DJ, Vosik W, Cantral D. Diaphragmatic paralysis following cervical chiropractic manipulation: case report and review. Chest. 2001;119:638-40.
88. Sedat J, Dib M, Mahagne MH, Lonjon M, Paquis P. Stroke after chiropractic manipulation as a result of extracranial postero-inferior cerebellar artery dissection. J Manipulative Physiol Ther. 2002;25:588-90.
89. Segal DH, Lidov MW, Camins MB. Cervical epidural hematoma after chiropractic manipulation in a healthy young woman: case report. Neurosurgery. 1996;39:1043-5.
90. Sherman MR, Smialek JE, Zane WE. Pathogenesis of vertebral artery occlusion following cervical spine manipulation. Arch Pathol Lab Med. 1987;111:851-3.
91. Sinel M, Smith D. Thalamic infarction secondary to cervical manipulation. Arch Phys Med Rehabil. 1993;74:543-6.
92. Sivakumaran P, Wilsher M. Diaphragmatic palsy and chiropractic manipulation. N Z Med J. 1995;108:279-80.
93. Smith RA, Estridge MN. Neurologic complications of head and neck manipulations. JAMA. 1962;182:528-31.
94. Soper JR, Parker GD, Hallinan JM. Vertebral artery dissection diagnosed with CT. AJNR Am J Neuroradiol. 1995;16(4 Suppl):952-4.
95. Sturzenegger M. Vertebral artery dissection following manipulation of the cervical vertebrae. Schweiz Med Wochenschr. 1993:123:1389-99.
96. Suh SI, Koh SB, Choi EJ, Kim BJ, Park MK, Park KW, et al. Intracranial hypotension induced by cervical spine chiropractic manipulation. Spine (Phila Pa 1976). 2005;30:E340-2.
97. Tinel D, Bliznakova E, Juhel C, Gallien P, Brissot R. Vertebrobasilar ischemia after cervical spine manipulation: a case renort. Ann Readapt Med Phys. 2008:51:403-14.
98. Tolge C, Iyer V, McConnell J. Phrenic nerve palsy accompanying chiropractic manipulation of the neck. South Med J. 1993;86:68R-90.
99. Tseng SH, Chen Y, Lin SM, Wang CH. Cervical epidural hematoma after spinal manipulation therapy: case report. J Trauma 2002;52:585-6
100. Tseng SH, Lin SM, Chen Y, Wang CH. Ruptured cervical disc after spinal manipulation therapy: report of two cases. Spine (Phila Pa 1976) 2002;27:E80-82
101. Vibert D, Rohr-Le Floch J, Gauthier G. Vertigo as manifestation of vertebral artery dissection after chiropractic neck manipulations. ORL J Otorhinolaryngol Relat Spec. 1993;55:140-2
102. Wang JL, Lin JJ, Lin JC, Lie CC, Shih TP, Tsao WL. Vertebral artery dissection complicated by cervical manipulation: a case report. Zhonghua Yi Xue Za Zhi (Taipei). 1995; 55:496-500.
103. Weintraub MI. Dormant foramen magnum meningioma 'activated' by chiropractic manipulation. N Y State J Med. 1983;83:1039-40.
104. Whedon JM, Quebada PB, Roberts DW, Radwan TA. Spinal epidural hematoma after spinal manipulative therapy in a patient undergoing anticoagulant therapy: a case report. J Manipulative Physiol Ther. 2006;29:582-5.
105. Wood MJ, Lang EK, Woolhandler GJ, Faludi HK. Traumatic vertebral artery thrombosis. J La State Med Soc. 1971;123: 4l3-4
106. Young YH, Chen CH. Acute vertigo following cervical manipulation. Laryngoscope 2003;113:659-62
107. Zupruk GM, Mehta Z. Brown-Sequard syndrome associated with posttraumatic cervical epidural hematoma: case report and review of the literature. Neurosurgery. 1989;25:278-80
108. Thomas LC, Rivett DA, Attia JR, Parsons M, Levi C. Risk factors and clinical features of craniocervical arterial dissection. Man Ther 2011;16:351-6
109. Bolton PS, Stick PE, Lord RS. Failure of clinical tests to predict cerebral ischemia before neck manipulation. J Manipulative Physinl Ther 1989;12:304-7
110. Thiel H, Rix G. Is it time to stop functional pre-manipulation testing of the cervical spine? Man Ther. 2005;10:154-8.
111. Westaway MD, Stratford P, Symons B. False-negative extension/rotation pre-manipulative screening test on a patient with an atretic and hypoplastic vertebral artery. Man Ther. 2003;8:120-7.
112. Kerry R, Taylor AJ, Mitchell J, McCarthy C, Brew J. Manual therapy and cervical arterial dysfunction, directions for the future: a clinical perspective. J Man Manipulative Ther. 2008; 16:39-48
113. Kerry R, Taylor AJ, Mitchell J, McCarthy C. Cervical arterial dysfunction and manual therapy: a critical literature review to inform professional practice. Man Ther. 2008;13:278-88.
114. Haldeman S, Kohlbeck FJ, McGregor M. Stroke, cerebral artery dissection, and cervical spine manipulation therapy. J Neurol 2002;249: 1098-104
115. Thiel HW, Bolton JE, Docherty S, Portlock JC. Safety of chiropractic manipulation of the cervical spine: a prospective national survey. Spine (Phila Pa 1976) 2007;32:2375-8
116. Cagnie B, Vinck E, Beernaert A, Cambier D. How common are side effects of spinal manipulation and can these side effects be predicted? Man Ther. 2004;9:151-6.
117. Senstad O, Leboeuf-Yde C, Borchgrevink C. Frequency and characteristics of side effects of spinal manipulative therapy. Spine (Phila Pa 1976). 1997:22:435-40.
118. Ernst E. Prospective investigations into the safety of spinal manipulation. J Pain Symptom Manage 2001;21:238-42
119. Schwartz NE, Vertinsky AT, Hirsch KG, Albers GW. Clinical and radiographic natural history of cervical artery dissections. J strnke Cerehrovasc Dis 2009;18:416-23
120. Austin N, DiFrancesco LM, Herzog W. Microstructural damage in arterial tissue exposed to repeated tensile strains. J Manipulative Physiol Ther 2010;33:14-9
121. Mintken PE, Derosa C, Little T, Smith B. A model for standardizing manipulation terminology in physical therapy practice. J Man Manip Ther. 2008;16:50-6.