| Manipulation in the presence of cervical spinal cord compression: a case series. | |
| | |
MedLine Citation:
|
PMID: 16584950 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: The purpose of this study is to present information from a series of patients with imaging findings of encroachment on the cervical spinal cord who were treated with chiropractic cervical manipulation. CASE SERIES: There were 27 patients (18 females, 9 males; age range, 23-65, mean age, 44.3 years) with neck and/or arm pain with findings of cervical spinal cord encroachment on magnetic resonance imaging. None of these patients had severe or acute myelopathy or advanced signal changes in the spinal cord indicative of myelomalacia. These patients were treated with a variety of approaches that included some form of cervical manipulation. The mean number of treatments that included manipulation was 12 (range, 2-32). Nineteen patients were treated with high-velocity, low-amplitude "thrust" manipulation, 9 patients were treated with low-velocity muscle energy technique, and 1 patient was treated with both methods. The mean patient-rated subjective improvement at the last follow-up reexamination was 70.0% (range, 10%-100%). From baseline to the last follow-up examination, the mean improvements in outcome measures were as follows: Bournemouth Neck Disability Questionnaire, 23.7 points (31%); Neck Disability Index, 6.4 points; and Numerical Pain Rating Scale, 3.9 points. In 3 patients, there was increased pain after manipulation that lasted from 1 to 4 days. There were no major complications, and in no patient did any increased pain after treatment last more than 4 days. No new neurologic symptoms or signs were seen in any of these patients. CONCLUSION: The finding of cervical spinal cord encroachment on magnetic resonance imaging, in and of itself, should not necessarily be considered an absolute contraindication to manipulation. However, because radicular and myelopathic complications to cervical manipulation have been reported in the literature, great care should be taken in all cases, particularly those in which anatomic conditions such as cord encroachment are present. |
| | |
Authors:
|
Donald R Murphy; Eric L Hurwitz; Amy A Gregory |
Publication Detail:
|
Type: Case Reports; Journal Article |
Journal Detail:
|
Title: Journal of manipulative and physiological therapeutics Volume: 29 ISSN: 1532-6586 ISO Abbreviation: J Manipulative Physiol Ther Publication Date: 2006 Mar-Apr |
Date Detail:
|
Created Date: 2006-04-04 Completed Date: 2006-07-20 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7807107 Medline TA: J Manipulative Physiol Ther Country: United States |
Other Details:
|
Languages: eng Pagination: 236-44 Citation Subset: IM |
Affiliation:
|
Rhode Island Spine Center, Pawtucket, RI, USA. drmurphy@rispinecenter.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Arm* Cervical Vertebrae* Disability Evaluation Female Humans Magnetic Resonance Imaging Male Manipulation, Chiropractic* / adverse effects, methods Middle Aged Neck Pain / complications, physiopathology, therapy* Pain / complications, physiopathology, therapy* Questionnaires Spinal Cord Compression / complications*, diagnosis Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Comparative study of hands-on therapy with active exercises vs education with active exercises for t...
Next Document: Gastroesophageal reflux disease in an 8-year-old boy: a case study.