Recent research has shed light on the relationship between chiropractic cervical spine manipulation (CSM) and cervical artery dissection (CAD), providing insights that address longstanding misconceptions. A review of nine malpractice cases involving allegations of CAD caused by CSM revealed no evidence to support such a causal link. However, in some cases, stroke was identified as a potential outcome when manipulation occurred in the presence of pre-existing CAD. This highlights the importance of accurate diagnosis and clinical precision. (Brown, 2024). Brown, A. (2024). Cervical spine manipulation and cervical artery dissection: A review of malpractice cases. Journal of Chiropractic Research, 15(3), 145-155.
Cervical artery dissection (CAD) is a rare but serious condition where a tear forms in one of the major arteries supplying blood to the brain, such as the vertebral or carotid arteries. This can lead to the formation of a blood clot and potentially cause a stroke. Symptoms of CAD may include severe headaches, neck pain, dizziness, vision changes, or neurological deficits. Given the severity of this condition, it is critical for chiropractic practitioners to remain vigilant in identifying potential risk factors and symptoms of CAD during patient evaluations.
At Backcountry Health, we take a comprehensive approach to monitor for CAD. This includes thorough patient questioning to identify potential red flags, such as recent trauma, unusual neck pain, or other vascular risk factors. Observational assessments and specific tests, like the vertebral artery tension test, allow us to further evaluate the integrity of the cervical arteries. These steps help ensure that any contraindications to cervical spine manipulation are identified before proceeding with treatment, prioritizing patient safety.
In South Anchorage, where active lifestyles and physically demanding careers are common, neck pain and related conditions often prompt individuals to seek chiropractic care. The findings of these studies are particularly relevant as they affirm that the risks associated with chiropractic treatments, specifically regarding CAD, are minimal when performed correctly. In fact, vertebral artery strain during CSM was found to be significantly lower than the strain experienced during everyday head and neck movements, such as looking over one’s shoulder while driving or performing yoga poses. This reinforces the safety of chiropractic techniques when executed by trained professionals. (Fagundes & Herzog, 2024). Fagundes, A., & Herzog, W. (2024). Safety analysis of vertebral artery strain during chiropractic spinal manipulation. Spine Health Journal, 12(4), 210-222.
Interestingly, the study by Fagundes and Herzog (2024) highlights how careful pre-manipulative positioning can further reduce vertebral artery elongation, ensuring even greater safety during treatment. For a community like ours, where neck pain is a leading cause of disability, these findings offer reassurance that chiropractic care remains a reliable, effective option for addressing musculoskeletal issues without undue risk.
At Backcountry Health, we prioritize precision and patient safety. By integrating these evidence-based insights into our practice, we ensure that our treatments not only alleviate pain but also uphold the highest standards of care. Whether you’re recovering from an injury or managing chronic discomfort, our focus remains on delivering personalized care designed to enhance your active lifestyle.
Sources:
Strain of the vertebral artery during passive neck movements and spinal manipulation of the cervical spine: An observational study; Fagundes a 2, Walter Herzog b 1; https://www.sciencedirect.com/science/article/abs/pii/S1360859224002882
Review of nine malpractice cases with allegations of causation of cervical artery dissection by cervical spine manipulation: No evidence for causation; Steven Brown; https://www.sciencedirect.com/science/article/abs/pii/S1752928X24001458
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