Acute paraplegia after chiropraxis
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Antonio Lopez-Gonzalez • Maria Peris-Celda
- چاپ و سال / کشور: 2010
Description
Spinal manipulation is a form of back and other musculoskeletal pain treatment that often involves a highvelocity thrust, a technique in which the joints are adjusted rapidly. The main objective of chiropractors is to correct spinal malalignment and relieve the nerves, allowing them to function optimally (Ernst In: Expert Rev Neurother 7:1451–1452, 2007; Oppenheim et al. In: Spine J 5:660– 666, 2005). The evidence for the effectiveness of this treatment based on randomized clinical trials still remains uncertain (Cassidy et al. In: Spine 33(4 suppl): S176–S183, 2008; Dupeyron et al. In: Ann Readapt Med Phys 46:33– 40, 2003; Ernst et al. In: Expert Rev Neurother 7:1451– 1452, 2007; Hurwitz et al. In: J Manipulative Physiol Ther 27:16–25, 2007; Thiel et al. In: Spine 32: 2375–2378, 2007). Several case reports and series have been focusing on the risks of chiropraxis, especially on the cervical spine, although the risk/benefit ratio for certain selected patients could be acceptable (Powell et al.In: Neurosurgery 33:73– 78, 1993). We describe the case of a 45-year-old woman who suffered complete paraplegia shortly after a chiropractic maneuver in the thoracic spine. Dorsal CT showed a calcified disc herniation at the T8–T9 level and MRI revealed a diffuse spinal cord ischemia from T6 to the conus medullaris without spinal cord compression at the level of herniation. Despite a normal arteriography, authors suggest a vascular injury as the cause of the deficit.
Eur Spine J (2011) 20 (Suppl 2):S143–S146 DOI 10.1007/s00586-010-1443-5 Received: 28 January 2009 / Revised: 20 September 2009 / Accepted: 9 May 2010 / Published online: 16 June 2010
