Adverse Events Associated With Pediatric Spinal Manipulation: A Systematic Review

Abstract

Serious adverse events may be associated with pediatric spinal manipulation; neither causation nor incidence rates can be inferred from observational data. Conduct of a prospective population-based active surveillance study is required to properly assess the possibility of rare, yet serious, adverse events as a result of spinal manipulation on pediatric patients.

Complementary and Alternative Medicine in Autism: An Evidence-Based Approach to Negotiating Safe and Efficacious Interventions with Families

“…133 It is important to identify pre-existing conditions, such as spinal cord tumors before receiving chiropractic therapy. The cervical spine in children may be particularly vulnerable to injury.…”

Conservative Care of Pediatric Acquired Torticollis: A Report of 2 Cases

“…24,31,32 There appear to be no negative reports in the pediatric or adult literature describing adverse consequences with conservative care for acquired torticollis of muscular origin. 23 One of the main therapies, myofascial release, is typically tolerated well and carries no risks beyond post-treatment soreness. The same principles of muscle relaxation may apply in the acute versus chronic condition.…”

“…17 There have been reviews on the safety of chiropractic manipulation for pediatric patients that concluded that there is insufficient evidence to establish causation, but that adverse events are rare and may not exceed those of other interventions. [23][24][25][26] The literature is not reflective of the prevalence of the benign forms of acquired torticollis that approach 80% of cases, nor the successful outcomes of those in private practice. 3 A consensus guideline on best practices for chiropractic care for children was published after the submission of the 2 cases herein reported and provides similar lines of reasoning on safety and treatment methods described in this report.…”

Newspaper portrayals of spinal manipulation therapy: Canada, United States, and the United Kingdom

“…As noted, fewer than half of the articles discussed evidence of efficacy and less than a quarter touched on issues of risk. Given that these are, arguably, the two biggest health policy issues associated with SMT, 15,[21][22][23][24][25] the relative absence of coverage in most SMT articles is less than ideal. Indeed, might the large portion of the articles that were neutral in tone -and which did not mention efficacy, benefits or risks -imply that SMT is a routine, effective and safe therapy to treat back pain and sports-related injuries?…”