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PubMed1985

Review of the literature supporting a scientific basis for the chiropractic subluxation complex.

A review of the literature reveals strong evidence for both the mechanical model of disease production (structural) and the neurobiological model (functional). Outdated models which attempt to describe a scientific basis for chiropractic theory are inadequate and indeed harmful to the progress and acceptance of chiropractic. Pragmatic or empirical arguments that "Chiropractic works and that's what counts" have served a useful purpose, but now must be augmented by extant research findings. The "paradigm shift" is on. Research investigators around the world are focusing on the multiple components of the chiropractic subluxation complex (CSC), a definitive, provable clinical entity. No longer can "informed" critics support the accusation that "chiropractic practice is based upon irrational, untenable premises." Only a few more pieces of the puzzle need to be fitted into place to produce the "big picture," i.e., the vertebral column is one of the most neglected vital organs in the human body--the sine qua non of the neurobiomechanical system--which influences every structure and function. Historically, its role in maintaining health has been almost totally ignored and for nearly a century chiropractors have battled against the consequences of this neglect. The scientific community is about to see that chiropractic is leading the way in discovering the "new world" in health care. Past, present and future research is discussed.

Afferent Pathways↗
PubMedDate not supplied

"Research" and "science" in the first half of the chiropractic century.

In the first 50 years of the chiropractic profession, a variety of unorthodox meanings for the terms "research," "science" and related words were in evidence. In harmony with popular conceptions of the day, science was constructed as a relatively static body of knowledge and was thought to reflect the will of God. Research was an ill-defined activity, and acquisition of new knowledge did not involve the experimental methodology that increasingly took hold in biology and medicine in the twentieth century. Chiropractors often viewed science and research as marketing strategies. Clinical data collection, when it occurred at all, was not described in sufficient detail to permit replication. Results were enthusiastically interpreted as indisputable proof of investigators' a priori assumptions about the effectiveness of chiropractic methods. A few in the profession recognized the general lack of understanding of the scientific method and sought reform from within. However, the colleges were unwilling to introduce coursework in research methods. At the end of World War II, the broad-scope national association of chiropractors in the United States established a nonprofit foundation for the purpose of raising funds for chiropractic research and education. Research plans were poorly conceived and grandiose: the first major initiative of the Chiropractic Research Foundation involved a nationwide publicity and fund-raising campaign modeled after the March of Dimes. When these efforts failed and the possibility of establishing free-standing research centers collapsed, the Foundation sought to shift responsibility for research to the schools. The poverty-stricken chiropractic colleges lacked the research sophistication for this task. Several more decades would pass before a sustained research effort and interest in clinical experimentation would become evident in chiropractic.

Chiropractic↗
PubMed1995

Resource-Based Relative Value Scales: impacts and recommendations relative to chiropractic practice.

PURPOSE: The American health care financing and delivery system is changing at a rapid pace. As part of recent reform of payment systems for physician services, Medicare has adopted a resource-based relative value scale (RBRVS) that is becoming a national standard. Research has now documented characteristics of physicians' work and the overhead for providing specific health services for most medical specialties and disciplines. This information is being used to develop service descriptions (billing codes) and reimbursement levels. No such data exist relative to chiropractic, which may hinder chiropractic's efforts to be included in evolving reimbursement schemes. RBRVS and its relevance to chiropractic is reviewed, information on work levels and practice costs is discussed, chiropractic practice is reviewed and a research and policy agenda for documenting chiropractic work, overhead and service descriptions is provided. METHODOLOGY: A manual systemic review of available recent and relevant medical and chiropractic literature was undertaken to characterize how the RBRVS system for reimbursement of physician services was developed and implemented. Payer and trade association literature was used to determine what established work value and practice costs for DCs there are. Published payment scales from governmental commissions were also obtained. CONCLUSIONS: Resources are urgently needed to survey levels of work by chiropractors in providing their various health services. The methodology should be the one used by the Health Care Financing Administration to assess other specialties. A range of generic manipulation codes should be developed and tested in a similar fashion for submission for inclusion in Physician's Current Procedural Terminology (CPT). A seed range of descriptions is presented. A systematic collection of practice overhead costs and malpractice risk should be undertaken and documented using standardized methodology.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1995

Medical referral for chiropractic care: a survey of "unconventional" medical practitioners.

OBJECTIVE: To ascertain the attitude toward chiropractic care of Australian medical practitioners who had previously demonstrated a willingness to contemplate a nonconventional mode of clinical intervention. DESIGN: A descriptive study in which eight hundred and twenty (820) medical practitioners were invited to respond to a mailed questionnaire. PARTICIPANTS: Only medical practitioners who had demonstrated an interest in at least one form of nonconventional intervention were surveyed. Seven hundred and ninety-six (796) medical practitioners who subscribe to a professional organization committed to 'alternative' nutritional approaches in health care were mailed a questionnaire. Twenty-four practitioners known to be sympathetic to chiropractic were also included. The response rate was 27%. RESULTS: One quarter of respondents never refer patients to a chiropractor. The major reason given for nonreferral is that physiotherapy is the preferred option. Almost half of the medical practitioners who never refer to chiropractors use manipulation themselves. Half of the medical practitioners who have never referred or have occasionally referred were unsure which of their patients would benefit from chiropractic care. Important referral criteria used by medical practitioners who do undertake chiropractic referral are, in order of importance: prior personal knowledge, the practitioner's professional reputation, qualifications and practice location. These medical practitioners believe that between one and three of every four patients referred received benefit from chiropractic care. CONCLUSIONS: Increased contact between chiropractors and the medical practitioners who were surveyed could lead to a better appreciation of chiropractic's potential contribution in health care.

Attitude of Health Personnel↗
PubMed1994

Conservative treatment of torn medial meniscus via mechanical force, manually assisted short lever chiropractic adjusting procedures.

OBJECTIVE: To present the first reported case of successful chiropractic intervention in treatment of a torn medial meniscus of the knee, the meniscal tear being documented by magnetic resonance imaging (MRI). CLINICAL FEATURES: A 54-yr-old woman complaining of right knee pain of several months' duration with accompanying marked functional impairment was diagnosed as having a tear in the posterior horn of the ipsilateral medial meniscus, verified by MRI studies of the same. Independent consultation with three medical specialists resulted in the unanimous decision that surgical intervention for the purpose of meniscectomy provided the only therapeutic approach indicated for the problem. However, the patient was reticent to undergo said surgical procedure and chose, instead, to utilize chiropractic care and conservative management in an effort to resolve her condition without having to resort to surgery. INTERVENTION AND OUTCOME: The patient received chiropractic treatment to the knee via mechanical force, manually assisted short lever chiropractic adjusting procedures (MFMA) utilizing an Activator Adjusting Instrument. Auxiliary treatment included the use of homeopathic therapy as an adjunct to chiropractic care. Said treatment resulted in a complete resolution of the patient's disability, the patient recovering full function of the knee joint and achieving an asymptomatic status without having to submit to surgical intervention and its possible adverse sequelae. CONCLUSIONS: Conservative management of meniscal tears via chiropractic treatment may provide a therapeutically effective and financially cost containing alternative to routine meniscectomy in certain cases involving torn medial menisci of the knee.

Chiropractic↗
PubMed1994

The relative impact of chiropractic vs. medical management of low back pain on health status in a multispecialty group practice.

PURPOSE: The objective of the study was to compare chiropractic management and medical management of low back pain of musculoskeletal etiology in a multispecialty group practice. STUDY DESIGN: The design was a retrospective cohort study in which the subcohorts were defined by source of low back pain care and identified before follow-up was complete. Data collection occurred at the end of the third month following their initial visits. One hundred and three chiropractic patients and 187 medical patients aged 16 or greater who had not been treated within the preceding month of their initial visit participated. MAIN FINDINGS: A greater proportion of chiropractic than medical patients perceived their treatment to be successful (RR = 1.91, 95% CI = 1.29, 2.82), had 0 days with low back pain during the week preceding the evaluation (RR = 1.60, 95% CI = 1.00, 2.59), and had no functional impairment due to low back pain after 3 months following their initial visit according to the Roland-Morris Disability Questionnaire (RR = 1.42, 95% CI = 0.81, 2.50). General health status was similar for both chiropractic and medical patients. CONCLUSIONS: Chiropractic care was at least as effective as medical care in reducing low back pain and functional disability due to low back pain. Chiropractic patients were more likely to perceive their treatment to be successful in reducing low back pain compared to medical patients.

Adult↗
PubMed1993

Patient satisfaction with chiropractic care.

OBJECTIVE: To determine the attitudes of patients regarding the process and result of chiropractic care and to identify patient characteristics which might predict satisfaction. DESIGN: Mailed survey consisting of a patient satisfaction questionnaire composed of 32 attitude statements accompanied by a five-point Likert scale, a personal information questionnaire and a doctor questionnaire providing clinical information about the patient. SETTING: Nonrandom sample of chiropractic doctors engaged in private practice. PATIENTS: Survey questionnaires were mailed to 541 new and returning chiropractic patients seeking care between June 1988 and August 1989, with a response rate of 69.5% (n = 376). RESULTS: Survey items were organized into scales and subscales from which response means were calculated reflecting attitudes about specific dimensions of care. Women responding to the survey were slightly more satisfied with the care they received than men, but other patient characteristics did not influence response means for questions referring to general satisfaction. Patients were most satisfied with the accessibility of their doctors and least satisfied with the financial aspects of treatment--especially those who reported lower incomes and no insurance coverage. Finally, among a variety of factors which might influence patient satisfaction, we found that the patient's perception of treatment outcome was the most important predictive variable. A slightly greater degree of dissatisfaction was reported by a small percentage (12%) of patients who also reported that there was either no improvement in their health problem, or minimal improvement, following chiropractic care. CONCLUSIONS: Patients expressed high levels of satisfaction with their doctors and the care they received. Although women were slightly more satisfied than men, other patient characteristics such as level of education, income, employment status or previous chiropractic care did not influence response means. Future research is needed to determine if the way in which chiropractic care is rendered affects patient satisfaction.

Adult↗
PubMed1995

Chiropractic care, including craniosacral therapy, during pregnancy: a static-group comparison of obstetric interventions during labor and delivery.

OBJECTIVE: To determine whether the addition of chiropractic care including craniosacral therapy to a regimen of standard obstetric pregnancy results in fewer obstetric interventions during labor and delivery. DESIGN: Retrospective, case-matched, static-group comparison. SETTING: The study group was obtained from a college faculty-based clinic and received chiropractic care in addition to their routine obstetrical care. The setting for the comparison group was unkown, but the care rendered was presumed to be primary medical obstetric care only. PATIENTS: A consecutive sample of 63 pregnant women who sought chiropractic care within the period under study. The reason for seeking care was not necessarily related to the pregnancy. The sample was primarily between 18 and 35 yr, non-Hispanic caucasian and primiparous. After selection and matching criteria, 35 patients remained in the study group. INTERVENTION: Chiropractic care and craniosacral therapy delivered during pregnancy vs. unknown care within the same county. MAIN OUTCOME MEASURES: Obstetric interventions during labor and delivery as reported by the birth attendant on the certificate of live birth. RESULTS: No statistical differences were detected in the rates of obstetric interventions used during labor or delivery between the two samples. Approximate large-sample 95% confidence intervals are provided. CONCLUSION: Because of the limitations in the design of the project, this study provides no evidence that the addition of chiropractic care and craniosacral therapy during pregnancy results in any observable benefit or detriment with regard to obstetric interventions used during labor and delivery and that chiropractic care for pregnancy-related neuromusculoskeletal disorders should not complicate labor or delivery.

Adolescent↗
PubMed1997

Chiropractic care for women with chronic pelvic pain: a prospective single-group intervention study.

OBJECTIVE: To assess the role of chiropractic care for women with chronic pelvic pain (CPP) as a first step in designing a randomized clinical trial. DESIGN: Prospective single-group intervention study. SETTING: Chiropractic Research Center. SUBJECTS: Nineteen volunteer female subjects meeting inclusion/exclusion criteria for chiropractic treatment of chronic pelvic pain. INTERVENTIONS: Chiropractic treatment consisting of flexion/distraction and trigger point techniques administered by faculty clinician over a period of 6 wk. MAIN OUTCOME MEASURES: Pain Disability Index (PDI) was the primary measure; secondary outcome measures were Visual Analog Scale for pain (VAS), RAND-36 Health Survey and Beck Depression Inventory (BDI). All were administered at baseline and at 6 wk. RESULTS: Eighteen subjects completed the study, with an attrition rate of 5%. The mean improvement in the PDI score was 13.0 points (p = .001); in the VAS it was 4.0 cm (p = .001); and in the BDI it was 6.1 points (p < .001). All eight subscales of the RAND-36 Health Survey increased post-intervention, with the largest differences in role function limitations because of physical problems (45.8%), emotional problems (44.4%) and pain (40.6%). CONCLUSION: The chiropractic treatment used in this study had positive short-term effects. These results will be used to design a randomized clinical trial to investigate the efficacy of chiropractic care in the treatment of CPP.

Adolescent↗
PubMed1996

A survey of radiographic impressions on a selected chiropractic patient population.

INTRODUCTION: The chiropractic profession relies heavily on conventional radiography for patient clinical evaluation. Although the modality is widely used, there exists surprisingly little descriptive information about the common radiographic findings seen on chiropractic patients. The goal of this study is to provide descriptive data regarding the frequency and type of radiographic findings seen in a convenience sample of chiropractic outpatients. METHODS: A group of 300 patient radiographic reports were selected from a chiropractic teaching clinic. The group represented all those reports interpreted by the same chiropractic radiologist over the course of 3 months. Patient information, radiographic impressions and recommendations for further management were tabulated. RESULTS: In total, 300 reports (151 women and 149 men) were reviewed. Ages ranged from 6 to 82 yr (mean = 38.0, SD = 16.3). The majority of the patients had multiple skeletal areas examined. Most of the patients had X-rays of the spine (81.7%). Lytic bone changes, increased atlantodental intervals and fractures were among the more significant findings on the spinal films. A solitary pulmonary nodule and pneumonia was noted in the group of chest films. A vascular necrosis and fractures were important lesions found on the extremity films. CONCLUSIONS: Although degenerative disc and posterior joint changes were by far the most prevalent findings, more significant lesions were noted. Lesions such as lytic bone changes, increased atlantodental intervals and the solitary pulmonary nodule represented lesions that necessitated further evaluation. The findings emphasize a need for chiropractic training to address the early recognition and preliminary work-up of these relatively common lesions.

Adolescent↗
PubMedDate not supplied

The National Workshop to Develop the Chiropractic Research Agenda.

OBJECTIVE: To convene a national meeting to develop a research agenda for the chiropractic profession that targets the need to increase chiropractic's research capacity. DESIGN: The project was funded by a contract between the U.S. Health Resources and Services Administration Bureau of Health Professions (HRSA BHPr) and Palmer College of Chiropractic. Groundwork was established through a literature review and creation of position papers by teams of recognized authorities on the current status and recommendations for the future on the topics of clinical, educational, outcomes, basic science, and health services research and research infrastructure in chiropractic. The workshop took place July 12-14, 1996, in Washington, DC, with participants representing relevant segments of the research community of the health care professions, health professions education, health care policy, and all portions of the chiropractic community, including researchers, practitioners, faculty, administrators, and members of professional organizations. Work groups in each of the five target areas developed recommendations based on the seed material presented in the position papers. The results were incorporated into the final position papers. RESULTS: The primary outcome of the workshop was the completion of five position papers, one for each of the topics addressed. Also, a consensus process was initiated at the workshop on infrastructure needs of the profession but, because of the diversity of experience and opinions and the broad scope of the topic, was not completed by the end of the project year. CONCLUSIONS: Consensus was not reached on the development of a research agenda for the chiropractic profession, and a continuation of the contract has been agreed upon by HRSA BHPr to continue the process for another project year.

Chiropractic↗
PubMed1997

Chiropractic in Sweden: a short description of patients and treatment.

BACKGROUND: Most information on chiropractors and chiropractic emanates from North America. With an increasing number of chiropractors in Europe, it is important to produce relevant documentation concerning the European practice of chiropractic. OBJECTIVES: To describe the typical Swedish chiropractic patient and the treatment he/she receives. DESIGN: Chiropractors interviewed 10 consecutive patients using a standardized questionnaire. OUTCOME VARIABLES: Age, sex, previous treatment by chiropractor, area and duration of complaint, area and type of treatment and number of return visits (truncated data). RESULTS: Of the 86 chiropractors who could take part in the study, 78% participated. They each collected information on 10 consecutive patients (n = 628, response rate 73% of target sample), altogether 1858 return visits. Most patients were aged between 25 and 64 yr, with no difference in numbers between genders. Typically, they sought care for low back pain of up to 1 month's duration, were treated with spinal manipulation and received 2-3 treatments. Swedish chiropractic patients thus seem to seek care relatively early and undergo a short-lasting treatment program. However, a larger number of treatments was given to patients with problems of longer duration; patients who had not previously consulted a chiropractor presented with more long-lasting problems. CONCLUSIONS: The findings are in line with present-day concepts that emphasize the concurrent needs to avoid both the development of chronicity and long-lasting, invasive clinical intervention. Chiropractic care seems not to be a first choice therapy for those who have not previously received chiropractic care.

Adult↗
PubMedDate not supplied

Treatment of symptomatic lumbar disc herniation using activator methods chiropractic technique.

OBJECTIVE: To describe a case of symptomatic lumbar disc herniation, successfully treated via chiropractic intervention using Activator Methods Chiropractic Technique. CLINICAL FEATURES: A 26-yr-old man suffered from a chronic multisymptom complex composed of low back pain, left groin pain, left leg pain, left foot drop and associated muscle weakness with atrophy. The symptoms had persisted for more than 2 yr after an athletic injury. Magnetic resonance imaging evaluation revealed a 6-mm focal central disc protrusion with accompanying deformation of the thecal sac, consistent with the presenting symptoms. Lumbar spinal surgery had been recommended to the patient as the appropriate medical management for optimal outcome. INTERVENTION AND OUTCOME: The patient elected to pursue chiropractic treatment in an effort to resolve his condition via conservative management. Chiropractic intervention consisted of mechanical-force, manually assisted short-lever adjusting procedures, rendered via an Activator Adjusting Instrument (AAI). The patient responded favorably and his multisymptom complex resolved within 90 days of treatment. No residuals or recurrences were noted at examination over 1 yr later. CONCLUSION: This report suggests that chiropractic treatment of lumbar disc disorders may be effectively implemented, in certain cases, via mechanical-force, manually assisted adjusting procedures using an AAI. We speculate that the use of an AAI, combined with Activator methods, may provide definitive benefits over side-posture manipulation of the lumbar spine in treatment of resistive disc lesions, because of the lack of torsional stress imposed upon the disc during instrumental spinal adjustment. Further study should be made in this regard to determine the safest and most effective method to treat lumbar disc lesions in a chiropractic setting.

Adult↗
PubMed2002

Chiropractic.

Chiropractic is now more than a century old, and it is licensed throughout the United States and Canada and recognized in more than 60 countries worldwide. Doctors of Chiropractic receive training that is focused on the treatment of NMS conditions through manual and physical procedures, such as manipulation, massage, exercise, and nutrition. Most patients present to chiropractors with low back pain, neck pain, whiplash, and headaches. Numerous studies and expert panel reviews have supported the use of chiropractic and manipulation for these complaints. Satisfaction with chiropractic care for low back pain typically is good. Chiropractic, in general, offers safe and cost-effective procedures for selected musculoskeletal problems.

Canada↗
PubMed2006

Chiropractic: history and overview of theories and methods.

Chiropractic is one of the most controversial and poorly defined healthcare professions with recognition and licensure in the United States. Chiropractic was started by D. D. Palmer, a magnetic healer who formulated the vertebral subluxation theory. The profession was developed by his son, B. J. Palmer. Although the definition of chiropractic as a method of correcting vertebral subluxations to restore and maintain health is questionable, spinal manipulation is of value in the treatment of some types of back pain. The chiropractic profession is still based on the vertebral subluxation theory, and has the confusing image of a back specialty capable of treating a broad scope of health problems. Despite opposition to use of spinal manipulation as a method of treating a broad scope of health problems (as opposed to the generally accepted use of manipulation in the treatment of back pain), chiropractors seek support as primary care providers in alternative medicine. It is essential to understand the theories, philosophies, and methods of chiropractic for an objective evaluation.

Chiropractic↗
PubMed2000

Chiropractic care for children.

OBJECTIVE: To describe the practice characteristics and pediatric care of chiropractors. STUDY DESIGN: Cross-sectional, descriptive survey. SETTING: Chiropractic practices in the Boston, Mass, metropolitan area. PARTICIPANTS: One hundred fifty licensed chiropractors. MAIN OUTCOME MEASURES: Demographics, practice characteristics, and fee structure. Practitioners were also asked about their approach to childhood immunizations and a clinical scenario. Data were analyzed using simple descriptive statistics. RESULTS: Ninety (60%) chiropractors responded. All were white and 65% were men. Respondents had on average 122 patient visits weekly, of which 13 (11%) were from children and adolescents. Typical visit frequency ranged from 1 to 3 times weekly. Average visit fees were $82 and $38 (initial and follow-up) and 49% of the fees were covered by insurance. Seventy percent of the respondents recommended herbs and dietary supplements. For pediatric care, 30% reported actively recommending childhood immunizations; presented with a hypothetical 2-week-old neonate with a fever, 17% would treat the patient themselves rather than immediately refer the patient to a doctor of medicine, doctor of osteopathy, or an emergency facility. CONCLUSIONS: Children and adolescents constitute a substantial number of patients in chiropractics. An estimated 420000 pediatric chiropractic visits were made in the Boston metropolitan area in 1998, costing approximately $14 million. Pediatric chiropractic care is often inconsistent with recommended medical guidelines. National studies are needed to assess the safety, efficacy, and cost of chiropractic care for children.

Adolescent↗
PubMedDate not supplied

A practice-based study of patients with acute and chronic low back pain attending primary care and chiropractic physicians: two-week to 48-month follow-up.

OBJECTIVE: This study reports pain and disability outcomes up to 4 years for chiropractic and medical patients with low back pain (LBP) and assesses the influence of doctor type and pain duration on clinical outcomes. DESIGN: Prospective, longitudinal, nonrandomized, practice-based, observational study. SETTING: Fifty-one chiropractic and 14 general practice community clinics. SUBJECTS: A total of 2870 acute and chronic ambulatory patients with LBP of mechanical origin. METHODS: Sixty chiropractic (DC) and 111 general practice (MD) physicians participated. Primary outcomes were pain, using a 100-point visual analogue scale (VAS), and functional disability, using the Revised Oswestry Disability Questionnaire. These were measured at baseline and 8 time points. Regression analysis compared acute and chronic DC and MD patients after correcting for baseline differences in the 4 cohorts. RESULTS: Most improvement was seen by 3 months and sustained for 1 year; exacerbation was seen thereafter. Acute patients demonstrated greater relief at all time points. A clinically important advantage for chiropractic patients was seen in chronic patients in the short-term (>10 VAS points), and both acute and chronic chiropractic patients experienced somewhat greater relief up to 1 year (P<.000). The advantage for DC care was prominent for chronic patients with leg pain below the knee (P<.001). More than 50% of chronic patients had over 50 days of pain in the third year. CONCLUSION: Study findings were consistent with systematic reviews of the efficacy of spinal manipulation for pain and disability in acute and chronic LBP. Patient choice and interdisciplinary referral should be prime considerations by physicians, policymakers, and third-party payers in identifying health services for patients with LBP.

Acute Disease↗
PubMed2004

The amelioration of symptoms in cervical spinal stenosis with spinal cord deformation through specific chiropractic manipulation: a case report with long-term follow-up.

OBJECTIVE: To describe the chiropractic management of a patient with paresthesia on the entire left side of her body and magnetic resonance imaging (MRI)-documented cervical spinal cord deformation secondary to cervical spinal stenosis. CLINICAL FEATURES: A 70-year-old special education teacher had neck pain, headaches, and burning paresthesia on the entire left side of her body. These symptoms developed within hours of being injured in a side-impact motor vehicle accident. Prior to her visit, she had been misdiagnosed with a cerebrovascular accident. INTERVENTION AND OUTCOMES: Additional diagnostic studies revealed that the patient was suffering from cervical spinal stenosis with spinal cord deformation. Two manipulative technique systems (Advanced Biostructural Therapy and Atlas Coccygeal Technique) unique to the chiropractic profession and based on the theory of relief of adverse mechanical neural tension were administered to the patient. This intervention provided complete relief of the patient's complaints. The patient remained symptom-free at long-term follow-up, 1 year postaccident. CONCLUSION: There is a paucity of published reports describing the treatment of cervical spinal stenosis through manipulative methods. Existing reports of the manipulative management of cervical spondylosis suggest that traditional manual therapy is ineffective or even contraindicated. This case reports the excellent short-term and long-term response of a 70-year-old patient with MRI-documented cervical spinal stenosis and spinal cord deformation to less traditional, uniquely chiropractic manipulative techniques. This appears to be the first case (reported in the indexed literature) that describes the successful amelioration of the symptoms of cervical spinal stenosis through chiropractic manipulation. More research into the less traditional chiropractic systems of spinal manipulation should be undertaken.

Accidents, Traffic↗