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Grand Rounds 05/21/14 @ BID-Needham - David E. Thaler, MD, PhD  

The Case of Ms LL, or Illegal Use of Hands: The Risk of Chiropractic Manipulation and Cervical Arterial Dissections
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Speaker: Date: Topic

David E. Thaler, MD, PhD

May 21, 2014

The Case of Ms LL, or Illegal Use of Hands: The Risk of Chiropractic Manipulation and Cervical Arterial Dissections

      

    Responsibility for Content

    The WebEx video, PowerPoint presentation, take-away points and article links were sent by the Medical Library and the CME Committee.

    Diane E. Young, Information Specialist

    dyoung3@bidmc.harvard.edu

     

        

      Article: Beware the Spinal Trap by Simon Singh

      Take-Away Points of the Presentation

      1. Cervical spine manipulation therapy (SMT) has been associated with cervical artery dissection and stroke. The causal connection between SMT and dissection comes from the known stretching of the vertebral and carotid arteries that occurs during neck manipulation. Neck manipulation is an independent risk factor for vertebral artery dissection.

      2. A link has been suggested between an artery-to-artery embolism in highly calcified cervical vessels as an additional risk factor for SMT-induced embolism in the absence of dissection.

      3. Carotid dissection can be asymptomatic, and therefore, its incidence may be underestimated.

          
         

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