Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 20238
  Title Cervical myelopathy: A case report of a "near-miss" complication to cervical manipulation [case report]
Journal J Manipulative Physiol Ther. 2008 Sep;31(7):553-557
Peer Review Yes
Publication Type Case Report
Abstract/Notes OBJECTIVE: Cases have been reported in which radiculopathy or myelopathy secondary to herniated disk has occurred after cervical manipulation. In each case, it is not possible to determine whether the neurologic symptoms and signs were directly caused by the manipulation or whether they developed as part of the natural history of the disorder. The purpose of this article is to report a case in which a patient with radiculopathy secondary to herniated disk was scheduled to receive manipulation but just before receiving this treatment developed acute myelopathy.

CLINICAL FEATURES: A patient with arm pain and numbness was referred by a neurosurgeon for nonsurgical consult. He had a large C5-6 disk herniation with no signs or symptoms of myelopathy. He was determined to be a candidate for nonsurgical intervention, including manipulation. Manipulative treatment was planned for the second visit.

INTERVENTION AND OUTCOME: Ten days after the initial visit, and before any manipulative treatment being rendered, the patient developed symptoms suggestive of myelopathy, which were later determined on examination to be related to acute myelopathy secondary to the disk herniation.

CONCLUSION: Herniated disk in the cervical spine can progress to myelopathy as part of the natural history of this condition. Because of this, any interpretation of myelopathy that occurs after cervical manipulation, or any other procedure, must be made with caution.

Click on the above link for the PubMed record for this case report; full text by subscription. This abstract is reproduced with the permission of the publisher.

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