A review of the literature relating to complications arising from manipulation of the cervical spine was conducted to assess incidence, mechanisms of pathology, predisposing factors, symptomatology, cautions, and contraindications. Primary emphasis was given to those cases in which a neurovascular insult was suspect. During the period of 1947 to 1980, some 29 reports were published which listed 46 cases, 11 of which were fatalities. It was concluded that a potential for these side effects to manipulation of the cervical spine does exist, but in view of the fact that more than 75-million such cervical spine manipulations are perfomed yearly in the United States alone, the incidence is very minimal. However, when such a side effect does occur, it is a significant concern to the afflicted patient. Consequently, such manipulations should not be performed by anyone not properly trained in the cautions and contraindications, and the correct technique procedures.
Author keywords: manipulation, cervical spine, complications and side effects, vertebrobasilar injury
Author affiliation: Associate professor of Physiological Therapeutics, Dean of Postgraduate Education, National College of Chiropractic
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