Gefährdung der A. vertebralis durch manuelle Therapie

Gutmann, G

doi:10.1007/978-3-642-69428-8_15

Cited by 2 publications

(3 citation statements)

References 15 publications

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“…These included 8 case-control or case-crossover analyses examining association between serious adverse events and spinal manual treatment, all investigating cervical arterial strokes [ 208 – 211 , 214 , 221 , 226 , 233 ]. An additional 5 studies surveyed neurologists [ 238 ] or manual therapists/manual medicine physicians [ 78 , 239 – 241 ] about adverse events in their patients that they reported to have occurred following manual treatment to the spine.…”

Section: Review Findingsmentioning

confidence: 99%

“…Risk estimated from RCTs was approximately 0.13% (13 per 10,000) patients, based on zero cases from 2301 patients. While estimates indicate the relative rarity of serious adverse events, there are nevertheless a number of retrospective surveys [ 23 , 142 , 212 , 239 ], case reports [ 19 – 184 ] and systematic reviews of case reports [ 266 , 272 , 278 ] describing serious complications following manual interventions to the spine.…”

Section: Review Findingsmentioning

confidence: 99%

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What are the risks of manual treatment of the spine? A scoping review for clinicians

Swait¹,

Finch²

2017

Chiropr Man Therap

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BackgroundCommunicating to patients the risks of manual treatment to the spine is an important, but challenging element of informed consent. This scoping review aimed to characterise and summarise the available literature on risks and to describe implications for clinical practice and research.MethodA methodological framework for scoping reviews was followed. Systematic searches were conducted during June 2017. The quantity, nature and sources of literature were described. Findings of included studies were narratively summarised, highlighting key clinical points.ResultsTwo hundred and fifty articles were included. Cases of serious adverse events were reported. Observational studies, randomised studies and systematic reviews were also identified, reporting both benign and serious adverse events.Benign adverse events were reported to occur commonly in adults and children. Predictive factors for risk are unclear, but for neck pain patients might include higher levels of neck disability or cervical manipulation. In neck pain patients benign adverse events may result in poorer short term, but not long term outcomes.Serious adverse event incidence estimates ranged from 1 per 2 million manipulations to 13 per 10,000 patients. Cases are reported in adults and children, including spinal or neurological problems as well as cervical arterial strokes. Case-control studies indicate some association, in the under 45 years age group, between manual interventions and cervical arterial stroke, however it is unclear whether this is causal. Elderly patients have no greater risk of traumatic injury compared with visiting a medical practitioner for neuro-musculoskeletal problems, however some underlying conditions may increase risk.ConclusionExisting literature indicates that benign adverse events following manual treatments to the spine are common, while serious adverse events are rare. The incidence and causal relationships with serious adverse events are challenging to establish, with gaps in the literature and inherent methodological limitations of studies. Clinicians should ensure that patients are informed of risks during the consent process. Since serious adverse events could result from pre-existing pathologies, assessment for signs or symptoms of these is important. Clinicians may also contribute to furthering understanding by utilising patient safety incident reporting and learning systems where adverse events have occurred.Electronic supplementary materialThe online version of this article (10.1186/s12998-017-0168-5) contains supplementary material, which is available to authorized users.

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Section: Review Findingsmentioning

confidence: 99%

Section: Review Findingsmentioning

confidence: 99%

What are the risks of manual treatment of the spine? A scoping review for clinicians

Swait¹,

Finch²

2017

Chiropr Man Therap

View full text Add to dashboard Cite

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“…However, poor recall or inability to trace case details means that results are unlikely to represent an accurate picture. A survey of delegates at a congress of the German Society of Manual Medicine (55 responses) yielded an estimate of 1±3 serious incidents per million cervical manipulations 15 . A postal survey of 368 members of the Swiss Society for Manual Medicine (response rate 55%) reported a ratio of 1 serious neurological complication per 383 750 cervical manipulations 16 .…”

Section: Introductionmentioning

confidence: 99%

Neurological complications of cervical spine manipulation

et al. 2001

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To obtain preliminary data on neurological complications of spinal manipulation in the UK all members of the Association of British Neurologists were asked to report cases referred to them of neurological complications occurring within 24 hours of cervical spine manipulation over a 12-month period. The response rate was 74%. 24 respondents reported at least one case each, contributing to a total of about 35 cases. These included 7 cases of stroke in brainstem territory (4 with confirmation of vertebral artery dissection), 2 cases of stroke in carotid territory and 1 case of acute subdural haematoma. There were 3 cases of myelopathy and 3 of cervical radiculopathy. Concern about neurological complications following cervical spine manipulation appears to be justified. A large long-term prospective study is required to determine the scale of the hazard.

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Gefährdung der A. vertebralis durch manuelle Therapie

Cited by 2 publications

References 15 publications

What are the risks of manual treatment of the spine? A scoping review for clinicians

What are the risks of manual treatment of the spine? A scoping review for clinicians

Neurological complications of cervical spine manipulation

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