Document Detail


Adverse effects of spinal manipulation: a systematic review.
MedLine Citation:
PMID:  17606755     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify adverse effects of spinal manipulation.
DESIGN: Systematic review of papers published since 2001.
SETTING: Six electronic databases.
MAIN OUTCOME MEASURES: Reports of adverse effects published between January 2001 and June 2006. There were no restrictions according to language of publication or research design of the reports.
RESULTS: The searches identified 32 case reports, four case series, two prospective series, three case-control studies and three surveys. In case reports or case series, more than 200 patients were suspected to have been seriously harmed. The most common serious adverse effects were due to vertebral artery dissections. The two prospective reports suggested that relatively mild adverse effects occur in 30% to 61% of all patients. The case-control studies suggested a causal relationship between spinal manipulation and the adverse effect. The survey data indicated that even serious adverse effects are rarely reported in the medical literature.
CONCLUSIONS: Spinal manipulation, particularly when performed on the upper spine, is frequently associated with mild to moderate adverse effects. It can also result in serious complications such as vertebral artery dissection followed by stroke. Currently, the incidence of such events is not known. In the interest of patient safety we should reconsider our policy towards the routine use of spinal manipulation.
Authors:
E Ernst
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of the Royal Society of Medicine     Volume:  100     ISSN:  0141-0768     ISO Abbreviation:  J R Soc Med     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-03     Completed Date:  2007-10-10     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  7802879     Medline TA:  J R Soc Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  330-8     Citation Subset:  IM    
Affiliation:
Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, Exeter, UK. Edzard.Ernst@pms.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Epidemiologic Methods
Humans
Manipulation, Spinal / adverse effects*
Medical Records
Vertebral Artery Dissection / etiology
Comments/Corrections
Comment In:
J R Soc Med. 2007 Oct;100(10):444-5; author reply 447   [PMID:  17911118 ]
J R Soc Med. 2007 Oct;100(10):444; author reply 447   [PMID:  17911119 ]
J R Soc Med. 2007 Oct;100(10):444; author reply 447   [PMID:  17911120 ]
J R Soc Med. 2007 Oct;100(10):446; author reply 447   [PMID:  17911124 ]
J R Soc Med. 2007 Oct;100(10):445; author reply 447   [PMID:  17911122 ]
J R Soc Med. 2007 Oct;100(10):446; author reply 447   [PMID:  17911123 ]
J R Soc Med. 2007 Oct;100(10):445-6; author reply 447   [PMID:  17911121 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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