Acute paraplegia after chiropraxis

López-González, Antonio; Peris-Celda, María

doi:10.1007/s00586-010-1443-5

Cited by 10 publications

(5 citation statements)

References 16 publications

(8 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The more frequently reported serious adverse events, attributed either to spinal manipulation or to chiropractor visits, include spinal cord injury following cervical, thoracic or lumbar manipulation (myelopathy, quadriplegia, paraplegia or Brown-Sequard syndrome) [ 20 , 27 , 29 , 35 , 38 , 46 , 47 , 67 , 73 , 77 , 90 , 102 , 105 , 106 , 108 , 118 , 125 , 126 , 139 , 146 , 154 , 162 , 167 , 169 , 171 , 177 , 183 , 184 , 190 , 194 , 197 ], cauda equina syndrome [ 19 , 27 , 29 , 43 , 58 , 64 , 109 , 125 , 143 , 195 , 203 ], dural tears (resulting in intracranial hypotension) [ 49 , 50 , 61 , 68 , 70 , 95 , 111 , 119 , 140 , 163 , 165 , 186 , 189 , 193 ], epidural haemotomas [ 99 , 101 , 104 , 146 , 153 , 159 , 166 ...…”

Section: Review Findingsmentioning

confidence: 99%

What are the risks of manual treatment of the spine? A scoping review for clinicians

Swait¹,

Finch²

2017

Chiropr Man Therap

View full text Add to dashboard Cite

BackgroundCommunicating to patients the risks of manual treatment to the spine is an important, but challenging element of informed consent. This scoping review aimed to characterise and summarise the available literature on risks and to describe implications for clinical practice and research.MethodA methodological framework for scoping reviews was followed. Systematic searches were conducted during June 2017. The quantity, nature and sources of literature were described. Findings of included studies were narratively summarised, highlighting key clinical points.ResultsTwo hundred and fifty articles were included. Cases of serious adverse events were reported. Observational studies, randomised studies and systematic reviews were also identified, reporting both benign and serious adverse events.Benign adverse events were reported to occur commonly in adults and children. Predictive factors for risk are unclear, but for neck pain patients might include higher levels of neck disability or cervical manipulation. In neck pain patients benign adverse events may result in poorer short term, but not long term outcomes.Serious adverse event incidence estimates ranged from 1 per 2 million manipulations to 13 per 10,000 patients. Cases are reported in adults and children, including spinal or neurological problems as well as cervical arterial strokes. Case-control studies indicate some association, in the under 45 years age group, between manual interventions and cervical arterial stroke, however it is unclear whether this is causal. Elderly patients have no greater risk of traumatic injury compared with visiting a medical practitioner for neuro-musculoskeletal problems, however some underlying conditions may increase risk.ConclusionExisting literature indicates that benign adverse events following manual treatments to the spine are common, while serious adverse events are rare. The incidence and causal relationships with serious adverse events are challenging to establish, with gaps in the literature and inherent methodological limitations of studies. Clinicians should ensure that patients are informed of risks during the consent process. Since serious adverse events could result from pre-existing pathologies, assessment for signs or symptoms of these is important. Clinicians may also contribute to furthering understanding by utilising patient safety incident reporting and learning systems where adverse events have occurred.Electronic supplementary materialThe online version of this article (10.1186/s12998-017-0168-5) contains supplementary material, which is available to authorized users.

show abstract

Section: Review Findingsmentioning

confidence: 99%

What are the risks of manual treatment of the spine? A scoping review for clinicians

Swait¹,

Finch²

2017

Chiropr Man Therap

View full text Add to dashboard Cite

show abstract

“…To date, 9 cases of radicular artery occlusion due to thoracic disc herniation have been reported (Table 1). [4][5][6][7][8][9][10][11] Only in one other patient has a posterior spinal artery infarct due to thoracic disc herniation been described in a larger series of spinal stroke. 12 Disc rupture may result in direct compression or stretching of the radicular artery, resulting in spasm or occlusion.…”

Section: Discussionmentioning

confidence: 99%

Spinal Cord Ischemia Related to Disc Herniation: Case Report and a Review of the Literature

Aalbers¹,

Groen²,

Appelman³

et al. 2021

IMCRJ

View full text Add to dashboard Cite

Symptoms of spinal cord ischemia can mimic myelopathy due to spinal cord compression in the acute phase. Thoracic disc herniation with limited spinal cord compression but rapid progression of neurological symptoms causes a clinical dilemma as to whether emergency decompression should be performed. We report a case of acute progressive myelopathy due to spinal cord ischemia related to thoracic disc herniation initially managed by Th8 laminectomy with reduction of the herniated disc. Repeat imaging showed T2weighted hyperintensity in the posterior cord. The clinical and radiological course supports posterior spinal artery ischemia. This case illustrates and a review of the literature shows that thoracic disc herniation may be complicated by ischemic myelopathy even in the absence of cord compression.

show abstract

“…Neurological complications are uncommon, occurring in one per million cervical manipulations [1]. Most reported complications of this therapy are case reports of vertebral artery dissection [2], disc herniation [3] and cervical fracture [4], but there have been reports of Brown-Sequard syndrome due to cord contusion [5], acute paraplegia due to ischaemia [6] and hemiplegia due to a spinal epidural haematoma [7].…”

Section: Discussionmentioning

confidence: 99%

Quadraparesis following Chiropractic Manipulation: A Case Report

Tabloie¹,

Aggarwal

2012

J Clin Case Rep

View full text Add to dashboard Cite

Chiropractic manipulation is a popular form of alternative therapy used in the treatment of acute and chronic pain. Neurological complications are uncommon, occurring in 1 per million cervical manipulations. We report a case of a 35-year old man who developed a C3/C4 quadraparesis, shortly after chiropractic manipulation to his neck for acute on chronic neck pain. A CT scan of his cervical spine showed a large central disc protrusion at C3/4 causing severe cord compression and underwent urgent C3/4 cervical decompression with fusion. He improved neurologically and after a period of inpatient rehabilitation he has discharged home, 3 weeks after presentation, independent in mobility and self care with minimal residual upper limb weakness, which resolved over the next few months. Even though neurological complications of spinal manipulation are well recognised, our case demonstrates the dangers of this popular form of alternative therapy that is generally seen to be benign. Lessons: Chiropractic manipulation is a popular form of alternative therapy used in the treatment of acute and chronic pain and neurological complications are uncommon, occurring in 1 per million cervical manipulations. Even though neurological complications of spinal manipulation are well recognised, our case demonstrates the dangers of a therapy that is generally seen to be benign. If the complication is identified as a neurological emergency, excellent functional recovery occurs. This case highlights the potential pitfalls of this form of treatment and the need for more strict medical control to minimise the risk of complications, especially at the cervical level. Introduction: Chiropractic spinal manipulation involves a high-velocity thrust to rapidly adjust joints and correct spinal misalignment and relieve pressure on nerves to allow them to function. Neurological complications of cervical manipulations are considered rare, occurring in 1 per million cervical manipulations [1]. Most complications reported of this therapy are case reports of vertebral artery dissection [2], disc herniation [3] and cervical fracture [4], but there have been reports of Brown-Sequard syndrome due to cord contusion [5], acute paraplegia due to ischaemia [6] and hemiplegia due to a spinal epidural haematoma [7]. Even though neurological complications of spinal manipulation are well recognized [8,9] our case demonstrates the dangers of this popular form of alternative therapy.

show abstract

Acute paraplegia after chiropraxis

Cited by 10 publications

References 16 publications

What are the risks of manual treatment of the spine? A scoping review for clinicians

What are the risks of manual treatment of the spine? A scoping review for clinicians

Spinal Cord Ischemia Related to Disc Herniation: Case Report and a Review of the Literature

Quadraparesis following Chiropractic Manipulation: A Case Report

Contact Info

Product

Resources

About