Systematic review of spinal manipulation: A balanced review of evidence?
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The article consists in a review of injuries for which claims were submitted to one or another of three insurance companies during a two-year period, and which had arisen in conjunction with manipulation of the cervical spine (n = 21), thoracic spine (n = 6), lumbar spine (n = 13), or the sacro-iliac joint (n = 14). Cervical spine manipulation had caused injury of the vertebral artery with resulting paralysis in three cases, and cervical disc herniation in three cases. Lumbar spine manipulation had caused disc herniation in six patients, of whom three had severe persistent problems. Of the 14 patients who had undergone manipulation of the sacroiliac joint, six had disc herniation which was operated with varying outcome. One patient with a compression fracture of an osteoporotic L3 vertebra developed paraparesis.
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