Ann Readapt Med Phys. 2003 Feb; 46(1): 33-40.

[Complications following vertebral manipulation-a survey of a French region physicians]

Dupeyron A, Vautravers P, Lecocq J, Isner-Horobeti ME.

Service de mÃ©decine physique et rÃ©adaptation, hÃ´pitaux universitaires, avenue MoliÃ¨re, 67000, Strasbourg, France. [email protected] <[email protected]>

INTRODUCTION: Recent studies have emphasized the incidence and the general underestimation in literature of spinal manipulation (SM) linked accident. The aim of this study was to estimate the frequency and the incidence of strokes, myelopathies, radiculopathies or osteoarticular accidents in a major French area. MATERIAL AND METHOD: We made a survey among 240 neurologists, neurosurgeons, rhumatologists and physicians concerning the number of accidents observed during the preceding two years. RESULTS: We obtained a response from 133 physicians and 93 cases of complication were reported. Most of these complications were radiculopathies (69%). Approximatively 50% occurred at the cervical level, less than 24 hours after SM with or without sligth aftereffects in 68%. The incidence of vertebro-basilar accidents was 30 times higher than in published series. CONCLUSION: Spinal manipulations should remain under very strict medical control.Physicians who practice SM should be able to choose the manual treatment and perform it themselves in order to minimize risks of complications, especially at the cervical level.