Is neck massage safe? A rare case of tetraplegia and spinal shock after neck manipulation

Ling, Tan Han; Zakaria, Amir Fariz; Abdullah, Ahmad Tajuddin Bin

doi:10.1177/2309499017690459

Cited by 7 publications

(7 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regarding treatment, our review of the literature has shown that the two attitudes are the same, namely a surgical approach [ 11 - 13 ] or conservative treatment [ 9 , 14 , 15 ], associated in all cases with boluses of corticosteroids with analgesic treatment. Staying in ICU depends on the general clinical state of the patient at admission.…”

Section: Discussionmentioning

confidence: 99%

Cervical epidural hematoma post-trauma: a case report

Housn¹,

Adeniran²,

Ouahabi³

2022

Pan Afr Med J

View full text Add to dashboard Cite

Post-traumatic spinal epidural cervical hematoma is defined as a collection of blood at the level of the epidural space following a trauma. It remains a rare presentation. We report here the case of a cervical epidural hematoma extending from C3 to C5, in a 55-year-old patient victim of a public traffic accident admitted one hour after trauma. Computed Tomography (CT) scan found a compressive epidural hematoma extending C3 to C5; the patient underwent a posterior surgical approach, which allowed to evacuate the hematoma. This rare clinical entity is an emergency diagnosis and management, which needs collaboration between, Intensive Care Unit (ICU) specialists, neurosurgeons, neuroradiologists, and physiotherapists for good outcomes and follow-up.

show abstract

Section: Discussionmentioning

confidence: 99%

Cervical epidural hematoma post-trauma: a case report

Housn¹,

Adeniran²,

Ouahabi³

2022

Pan Afr Med J

View full text Add to dashboard Cite

show abstract

“…All reported CEH cases have generally occurred posteriorly or posterolaterally. [5][6][7][8][9][10][11][12][13][14][15] The pathological mechanism of spinal epidural hematoma remains still unclear but the bleeding from the epidural vein plexus is the most widely accepted hypothesis for the mechanism of hematoma formation. 17 The most probable association could be explained by the anatomical lack of valves in the epidural venous system.…”

Section: Discussionmentioning

confidence: 99%

“…19 Cervical laminectomy has been the most described surgical procedure for decompression of spinal cord in patients with CEH. 5,7,[8][9][10]13 However, standard laminectomy has also been reported to result in late cervical deformities such as kyphosis or segmental instability. 20 Full recovery from all neurological deficits was reached by our patient some days after the emergency decompression surgery.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Cervical epidural hematoma (CEH) is an uncommon entity that can arise spontaneously or due to CSMT, cervical dislocation fractures, coagulopathies, thrombocytopenia, hemophilia, and immune diseases such as ankylosing spondylitis and Paget disease .3,4 Few cases of severe quadriplegia caused by neck manipulation have been reported. [5][6][7][8][9][10][11][12][13][14][15] Most of these cases suffered from various under-lying diseases, such as coagulation dysfunction…”

mentioning

confidence: 99%

See 1 more Smart Citation

Acute neck pain after manipulations in a healthy adolescent patient: a case report

Perrini¹

2021

JACCOA

View full text Add to dashboard Cite

It is renowned that cervical spinal manipulation therapy (CSMT) is widely used among the people. It is frequently involved in the multidisciplinary treatment approach for neck pain and stiffness. These kind of treatments are often offered by many medical institutions such as non-medical institutions. Although spinal manipulation is a simple and safe therapy compared to surgical or pharmacological treatments, the serious complications caused by neck manipulation cannot be ignored. These complications include vertebral artery dissection, spinal cord or root injury, phrenic nerve injury, cervical subluxation, and cerebrovascular accidents. 1,2 Cervical epidural hematoma (CEH) is an uncommon entity that can arise spontaneously or due to CSMT, cervical dislocation fractures, coagulopathies, thrombocytopenia, hemophilia, and immune diseases such as ankylosing spondylitis and Paget disease .3,4 Few cases of severe quadriplegia caused by neck manipulation have been reported. [5][6][7][8][9][10][11][12][13][14][15] Most of these cases suffered from various under-lying diseases, such as coagulation dysfunction

show abstract

“…Surgical treatment should be performed in patients with severe neurological deficits or progressive severe symptoms. In a case reported by Ling et al [7], surgery was performed after the patient was admitted for tetraplegia after neck manipulation. These authors believed an earlier surgical intervention would have delivered a better outcome and improvement.…”

Section: Discussionmentioning

confidence: 99%

Cervical epidural hematoma after spinal manipulation therapy: a case report

Chen

Feng

Tang

et al. 2019

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundCervical spinal manipulation therapy is a common non-invasive treatment for neck pain and stiffness, and has been widely used in the population. However, most people do not pay attention to the potential risks of neck manipulation, such as ligament damage, fractures, and spinal cord injuries. Epidural hematoma is a disease in which blood accumulates in the epidural space of the vertebral body. This disease is usually caused by trauma or iatrogenic surgery, and may be associated with blood coagulopathies, neoplasms, or degenerative spinal disease. Reports of epidural hematoma caused by cervical spinal manipulation are rare.Case presentationWe present the case of a patient with tetraplegia and spinal shock after neck manipulation. A physical examination of the patient on admission found tenderness in the neck and increased muscle tension in both upper limbs. The superficial sensation of the upper limb disappeared, but the deep sensation still remained. The lower extremity had 0/5 power on both sides. The sensation below the T2 level completely disappeared. A cervical magnetic resonance imaging scan showed an acute posterior epidural hematoma from the C3–T3 vertebrae. Ultimately, the patient underwent emergency hematoma removal and showed partial improvement in symptoms of paralysis during follow-up.ConclusionsAlthough spinal manipulation is simple and neck pain is common and recurrent in the general population, the basic condition and disease history of patients should be determined before manipulation. For high-risk patients, caution should be applied for cervical spinal manipulation or it should be prohibited. For a suspected hematoma, MRI should be used at an early stage to diagnose and locate the hematoma.

show abstract

Is neck massage safe? A rare case of tetraplegia and spinal shock after neck manipulation

Cited by 7 publications

References 8 publications

Cervical epidural hematoma post-trauma: a case report

Cervical epidural hematoma post-trauma: a case report

Acute neck pain after manipulations in a healthy adolescent patient: a case report

Cervical epidural hematoma after spinal manipulation therapy: a case report

Contact Info

Product

Resources

About