Wednesday, January 20, 2010

Quadriparesis After Chiropractic Manipulation for Neck Pain

From The American Journal of Medicine (text modified):

18 million people annually visit chiropractors for treatment of neck pain and spinal manipulative therapy is a frequently applied for back and neck pain.

A 41-year-old man with chronic neck pain presented with weakness of the legs after he underwent chiropractic manipulation. He recalled hearing a snapping sound during the manipulation. He felt tingling and numbness in his arms and legs immediately after the manipulation. After a few hours, he was unable to move his legs and presented to the hospital.

The patient continued to deteriorate in the motor power of the extremities and rapidly developed complete quadriparesis.

MRI of the cervical spine showed large C6-C7 disc herniation with cord edema

He was treated with IV methylprednisone. An emergent C6-C7 anterior cervical discectomy and fusion was done. He showed partial improvement and regained power in his upper extremities, but continues to remain paraplegic 3 months after the incident.

References:
Catastrophic complication of chiropractic manipulation: a report of quadriparesis. Talluri SK, Talluri J, Besur S, Kakarala R, Klair N. Am J Med. 2009 Nov;122(11):e3-4.
Image source: A cervical vertebra. Wikipedia, public domain.