Kusnezov Nicholas A, Velani Shamsha A, Lu Daniel C
Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA.
Surg Neurol Int. 2013 Mar 22;4(Suppl 2):S118-20. doi: 10.4103/2152-7806.109456. Print 2013.
There is a paucity of quality data on the incidence of adverse outcomes of chiropractic manipulation. Spontaneous intracranial hypotension (SIH) subsequent to cervical spinal manipulation has been documented. However, no imaging correlates have previously been presented demonstrating a clear causal relationship to manipulation with follow-up and correlating with clinical symptomatology.
We present a case of subacute cervical cerebrospinal fluid (CSF) leak resulting from chiropractic manipulation of the cervical spine. The patient is a 29-year-old female who received manipulation one week prior to developing symptoms of severe orthostatic headache, nausea, and vomiting. Magnetic resonance imaging (MRI) revealed a new C5-C6 ventral CSF collection. Symptomatic onset corresponded with the recent cervical chiropractic adjustment. We present serial imaging correlating with her symptomatology and review the pertinent literature on complications of chiropractic manipulation.
Our case of ventral CSF leak with symptoms of intracranial hypotension demonstrated spontaneous symptomatic resolution without permanent neurological sequelae.
关于整脊手法不良后果发生率的高质量数据匮乏。已有文献记载颈椎整脊手法后发生自发性颅内低压（SIH）。然而，此前尚未有影像学关联证据表明其与整脊手法存在明确的因果关系，且缺乏随访及与临床症状相关的研究。
我们报告一例因颈椎整脊手法导致的亚急性颈段脑脊液（CSF）漏病例。患者为一名29岁女性，在出现严重体位性头痛、恶心和呕吐症状前一周接受了整脊手法治疗。磁共振成像（MRI）显示C5 - C6椎体前方有新的脑脊液聚集。症状发作与近期的颈椎整脊调整相对应。我们展示了与她的症状相关的系列影像学检查结果，并回顾了有关整脊手法并发症的相关文献。
我们的这例伴有颅内低压症状的椎体前方脑脊液漏病例显示，症状可自发缓解，且无永久性神经后遗症。
