• Tuchin P

• Manipulation, Cervical / adverse effects
• Open Access Document
• Safety
• Vertebral Artery Dissection

Objective: Case reports are sometimes used in discussion about the role of cervical spine manipulative therapy (SMT) in vertebral artery dissection (VAD). Some authors of case reports also make incorrect statements regarding causality of SMT and these rare types of stroke. Case reports often have limited clinical details. This paper looks at the evidence presented in case reports.

Methods: A review of recent cervical artery dissection (CAD) case reports was conducted to assess what role SMT may play in the onset of CAD stroke. This paper assessed recent case reports of CAD and reviewed the clinical features of case reports and potential triggers of CAD stroke.

Results: A search of the Pubmed database found 16 papers (17 cases) using the terms “cervical spine manipulation”, “case report,” and “CAD” from 2019 to April 2024. The majority of case reports made inappropriate conclusions and provide little contribution to knowledge about SMT and CAD. Many case reports incorrectly used the term “chiropractic” when referring to SMT provided by a non-chiropractor (e.g. massage therapist). In addition, most case reports had minimal information regarding risk factors and the onset of any neck pain or headache, prior to SMT.

Conclusion: The chiropractic profession should be aware of inappropriate case report conclusions which incorrectly imply chiropractic manipulation as a cause of CAD.

Author keywords: Cervical Artery Dissection; Cervical Spine; Chiropractic Manipulation Case Report This abstract is reproduced with the permission of the publisher. Click on the above link for free full text.