Safety of chiropractic manipulation of the cervical spine: a prospective national survey.

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  • Author(s): Thiel HW;Thiel HW; Bolton JE; Docherty S; Portlock JC
  • Source:
    Spine [Spine (Phila Pa 1976)] 2007 Oct 01; Vol. 32 (21), pp. 2375-8; discussion 2379.
  • Publication Type:
    Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 7610646 Publication Model: Print Cited Medium: Internet ISSN: 1528-1159 (Electronic) Linking ISSN: 03622436 NLM ISO Abbreviation: Spine (Phila Pa 1976) Subsets: MEDLINE
    • Publication Information:
      Publication: Hagerstown, MD : Lippincott Williams & Wilkins
      Original Publication: Hagerstown, Md., Medical Dept., Harper & Row.
    • Subject Terms:
      Cervical Vertebrae* ; Data Collection*; Manipulation, Chiropractic/*adverse effects; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Manipulation, Spinal/adverse effects ; Middle Aged ; Nausea/epidemiology ; Nausea/etiology ; Neck Pain/epidemiology ; Neck Pain/etiology ; Prospective Studies ; Risk Factors
    • Abstract:
      Study Design: Prospective national survey.
      Objective: To estimate the risk of serious and relatively minor adverse events following chiropractic manipulation of the cervical spine by a sample of U.K. chiropractors.
      Summary of Background Data: The risk of a serious adverse event following chiropractic manipulation of the cervical spine is largely unknown. Estimates range from 1 in 200,000 to 1 in several million cervical spine manipulations.
      Methods: We studied treatment outcomes obtained from 19,722 patients. Manipulation was defined as the application of a high-velocity/low-amplitude or mechanically assisted thrust to the cervical spine. Serious adverse events, defined as "referred to hospital A&E and/or severe onset/worsening of symptoms immediately after treatment and/or resulted in persistent or significant disability/incapacity," and minor adverse events reported by patients as a worsening of presenting symptoms or onset of new symptoms, were recorded immediately, and up to 7 days, after treatment.
      Results: Data were obtained from 28,807 treatment consultations and 50,276 cervical spine manipulations. There were no reports of serious adverse events. This translates to an estimated risk of a serious adverse event of, at worse approximately 1 per 10,000 treatment consultations immediately after cervical spine manipulation, approximately 2 per 10,000 treatment consultations up to 7 days after treatment and approximately 6 per 100,000 cervical spine manipulations. Minor side effects with a possible neurologic involvement were more common. The highest risk immediately after treatment was fainting/dizziness/light-headedness in, at worse approximately 16 per 1000 treatment consultations. Up to 7 days after treatment, these risks were headache in, at worse approximately 4 per 100, numbness/tingling in upper limbs in, at worse approximately 15 per 1000 and fainting/dizziness/light-headedness in, at worse approximately 13 per 1000 treatment consultations.
      Conclusion: Although minor side effects following cervical spine manipulation were relatively common, the risk of a serious adverse event, immediately or up to 7 days after treatment, was low to very low.
    • Comments:
      Comment in: Spine (Phila Pa 1976). 2008 Mar 1;33(5):576-7; author reply 577. (PMID: 18317205)
    • Publication Date:
      Date Created: 20071002 Date Completed: 20071128 Latest Revision: 20090709
    • Publication Date:
      20240104
    • Accession Number:
      10.1097/BRS.0b013e3181557bb1
    • Accession Number:
      17906581