Chiropractic Manipulation of the Neck and Cervical Artery Dissection
Authors: Raymond E. Bertino, Arun V. Talkad, Jeffrey R. DeSanto, Jane H. Maksimovic, Shyam G. Patel
Journal: Annals of Internal Medicine (2012)

Letters17 July 2012Chiropractic Manipulation of the Neck and Cervical Artery DissectionRaymond E. Bertino, MD, Arun V. Talkad, MD, Jeffrey R. DeSanto, MD, Jane H. Maksimovic, DO, and Shyam G. Patel, MDRaymond E. Bertino, MDFrom University of Illinois College of Medicine at Peoria, Peoria, IL 61637., Arun V. Talkad, MDFrom University of Illinois College of Medicine at Peoria, Peoria, IL 61637., Jeffrey R. DeSanto, MDFrom University of Illinois College of Medicine at Peoria, Peoria, IL 61637., Jane H. Maksimovic, DOFrom University of Illinois College of Medicine at Peoria, Peoria, IL 61637., and Shyam G. Patel, MDFrom University of Illinois College of Medicine at Peoria, Peoria, IL 61637.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-2-201207170-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Chiropractic manipulation of the neck can cause cervical artery dissection and stroke, although the incidence of these complications is unknown (1–4). Patients younger than 45 years with vertebral artery dissection and stroke are 5 times more likely to have visited a chiropractor in the previous 30 days than an age-matched control group (1).Case Report: In mid-March 2012, a 37-year-old registered nurse with a history of chronic neck pain went to her chiropractor. She had seen the same chiropractor for 12 to 15 years, usually going once a month for cervical spine manipulation. Because of a new symptom (pain ...References1. Rothwell DM, Bondy SJ, Williams JI. Chiropractic manipulation and stroke: a population-based case-control study. Stroke. 2001;32:1054-60. [PMID: 11340209] CrossrefMedlineGoogle Scholar2. Smith WS, Johnston SC, Skalabrin EJ, Weaver M, Azari P, Albers GW, et al. Spinal manipulative therapy is an independent risk factor for vertebral artery dissection. Neurology. 2003;60:1424-8. [PMID: 12743225] CrossrefMedlineGoogle Scholar3. Reuter U, Hämling M, Kavuk I, Einhäupl KM, Schielke E. Vertebral artery dissections after chiropractic neck manipulation in Germany over three years. J Neurol. 2006;253:724-30. [PMID: 16511634] CrossrefMedlineGoogle Scholar4. Albuquerque FC, Hu YC, Dashti SR, Abla AA, Clark JC, Alkire B, et al. Craniocervical arterial dissections as sequelae of chiropractic manipulation: patterns of injury and management. J Neurosurg. 2011;115:1197-205. [PMID: 21923248] CrossrefMedlineGoogle Scholar5. Bronfort G, Evans R, Anderson AV, Svendsen KH, Bracha Y, Grimm RH. Spinal manipulation, medication, or home exercise with advice for acute and subacute neck pain: a randomized trial. Ann Intern Med. 2012;156:1-10. [PMID: 22213489] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Raymond E. Bertino, MD; Arun V. Talkad, MD; Jeffrey R. DeSanto, MD; Jane H. Maksimovic, DO; Shyam G. Patel, MDAffiliations: From University of Illinois College of Medicine at Peoria, Peoria, IL 61637.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byWhat are the risks of manual treatment of the spine? A scoping review for cliniciansKinematics Analysis of Cervical Rotation-Traction Manipulation Measured by a Motion Capture System 17 July 2012Volume 157, Issue 2Page: 150-152KeywordsAngiographyArteriesChiropracticComputed axial tomographyExerciseExercise therapyInfarctionMagnetic resonance imagingSpineStroke ePublished: 17 July 2012 Issue Published: 17 July 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...