Murphy Donald R
Rhode Island Spine Center, and Department of Community Health, Brown University School of Medicine, Providence, RI 02860, USA.
Spine J. 2006 Jul-Aug;6(4):459-63. doi: 10.1016/j.spinee.2006.01.019.
Spinal manipulation applied to the cervical spine is a relatively safe and effective treatment for neck pain and headache. However, complications of this form of treatment have been reported and these can at times be disabling and on rare occasions can be devastating. A postmanipulation complication being treated with a different form of manipulation has not previously been reported.
To report a case of a patient who was treated with manipulation and who developed neck, scapular, and arm pain and arm numbness after the sixth visit, which was later attributed to three herniated discs. The patient was subsequently treated with a nonsurgical approach that included, but was not limited to, a different form of manipulation with apparent resolution of the problem.
STUDY DESIGN/SETTING: The patient was a 38-year-old banker who began seeing a chiropractic physician for treatment that included cervical manipulation. On the sixth visit, he developed pain immediately after treatment which became severe and was accompanied by numbness in his arm. He saw a neurosurgeon who recommended surgery, but was subsequently seen by a different chiropractic physician and was treated nonsurgically.
The patient was found to have clinical signs of radiculopathy, including motor loss. Magnetic resonance imaging revealed disc herniations at C3-C4, C4-C5, and C5-C6.
The patient was treated by the author with an alternate approach that included non-high-velocity, low-amplitude manipulation and exercise with resolution of the problem.
This paper reports a case of a patient with radiculopathy secondary to multilevel disc herniations that appeared to be precipitated by cervical manipulation and who was treated nonsurgically with resolution of the problem. It is doubtful that the manipulation actually caused the disc herniations, but it is possible that it caused preexisting asymptomatic disc herniations to become symptomatic. Consideration should be given to nonsurgical referral of patients who have postmanipulative complications but do not need immediate surgery.
颈椎推拿是治疗颈部疼痛和头痛的一种相对安全有效的方法。然而，这种治疗方式的并发症已有报道，有时可能导致功能障碍，极少数情况下甚至可能造成严重后果。此前尚未有关于用另一种推拿方式治疗推拿后并发症的报道。
报告一例患者，该患者接受推拿治疗，在第六次就诊后出现颈部、肩胛部和手臂疼痛以及手臂麻木，后来被诊断为三个椎间盘突出。该患者随后接受了非手术治疗，包括但不限于另一种推拿方式，问题明显得到解决。
研究设计/背景：患者为一名38岁的银行家，开始接受一位整脊医师的治疗，其中包括颈椎推拿。在第六次就诊时，他在治疗后立即出现疼痛，疼痛逐渐加重并伴有手臂麻木。他咨询了一位神经外科医生，医生建议手术，但随后他又看了另一位整脊医师，并接受了非手术治疗。
发现该患者有神经根病的临床体征，包括运动功能丧失。磁共振成像显示C3 - C4、C4 - C5和C5 - C6椎间盘突出。
作者采用了一种替代方法对该患者进行治疗，包括非高速、低幅度推拿和运动，问题得到解决。
本文报告了一例因多节段椎间盘突出继发神经根病的患者，该症状似乎由颈椎推拿诱发，最终通过非手术治疗使问题得到解决。虽然推拿不太可能实际导致椎间盘突出，但有可能使原本无症状的椎间盘突出变得有症状。对于有推拿后并发症但不需要立即手术的患者，应考虑进行非手术转诊。
