Lewis M, Grundy D
Duke of Cornwall Spinal Treatment Centre, Odstock Hospital, Salisbury, Wilts, England.
Paraplegia. 1992 Nov;30(11):788-90. doi: 10.1038/sc.1992.151.
Neurological complications of neck manipulation are well recognised but are usually due to acute vascular incidents. However, we describe two patients with cervical spondylosis, who developed staphylococcal osteomyelitis of the cervical spine with progressive tetraplegia, apparently following manipulation of the neck by a chiropractor. Although it is possible that the manipulation resulted in cervical spine trauma sufficient to cause local haemorrhage, the area becoming a nidus for infection, it is also conceivable that the patients underwent neck manipulation in an attempt to relieve pain due to an already existing osteomyelitis of the cervical spine, and the manipulation may have hastened the onset of spinal cord paralysis. Clearly, this could have occurred, as the average time between the onset of symptoms and diagnosis of vertebral osteomyelitis in most published series is about 2 months. Approximately 80% of cases of osteomyelitis occur in the 50-70 age group, a group in which cervical spondylosis is extremely common. It would seem that neck manipulation is particularly contraindicated in older patients with cervical spondylosis.
颈部推拿的神经并发症已广为人知，但通常是由急性血管事件引起的。然而，我们描述了两名患有颈椎病的患者，他们在接受脊椎按摩师的颈部推拿后，出现了颈椎葡萄球菌骨髓炎并伴有进行性四肢瘫痪。虽然推拿有可能导致颈椎创伤足以引起局部出血，使该区域成为感染病灶，但也可以想象，患者进行颈部推拿是为了缓解因已存在的颈椎骨髓炎引起的疼痛，而推拿可能加速了脊髓麻痹的发作。显然，这种情况是有可能发生的，因为在大多数已发表的系列研究中，症状出现到诊断为椎体骨髓炎的平均时间约为2个月。大约80%的骨髓炎病例发生在50至70岁的年龄组，而颈椎病在这个年龄组极为常见。看来，对于患有颈椎病的老年患者，颈部推拿尤其禁忌。
