Published in:
01-07-2011 | Case Report
Acute paraplegia after chiropraxis
Authors:
Antonio Lopez-Gonzalez, Maria Peris-Celda
Published in:
European Spine Journal
|
Special Issue 2/2011
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Abstract
Spinal manipulation is a form of back and other musculoskeletal pain treatment that often involves a high-velocity 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.