Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 18493
  Title Pathological cervical fracture after spinal manipulation in a pregnant patient
Journal J Manipulative Physiol Ther. 2005 Oct;28(8):633-636
Peer Review Yes
Publication Type Case Report
Abstract/Notes OBJECTIVE: To present the rare case of a displaced odontoid fracture after manipulative treatment.

CLINICAL FEATURES: A 37-year-old, 15-week pregnant patient was referred with acute neck pain and a diffuse paravertebral swelling that started after cervical manipulation performed by her general medical practitioner 5 days before. Because of pregnancy, a cervical spine radiographic series was not obtained before treatment. Magnetic resonance imaging revealed a displaced odontoid fracture associated with a pathological process in the vertebral body of C2 and a paravertebral hematoma on the left side from C2 to C4.

INTERVENTION AND OUTCOME: After initial halo vest immobilization, an anterior-posterior fusion of C1-C2 was performed. The histological analysis showed features of an aneurysmal bone cyst. The patient was discharged and had an undisturbed pregnancy and was without any neurological complications.

CONCLUSIONS: Because of the weakening lesion in C2, the spinal manipulation most likely caused the displaced odontoid fracture. Special imaging should be performed, preferably with magnetic resonance imaging, when a patient experiences significant new symptoms after cervical manipulation.

Click on the above link for the PubMed record for this article; full text by subscription. The abstract is reproduced here with the permission of the publisher.
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