Kennell Kelly A, Daghfal Megan M, Patel Shyam G, DeSanto Jeffery R, Waterman G Scott, Bertino Raymond E
University of Illinois College of Medicine, Peoria, IL, USA.
William Beaumont Hospital, Royal Oak, MI, USA.
J Fam Pract. 2017 Sep;66(9):556-562.
The purpose of this study was to determine the frequency of patients seen at a single institution who were diagnosed with a cervical vessel dissection related to chiropractic neck manipulation.
We identified cases through a retrospective chart review of patients seen between April 2008 and March 2012 who had a diagnosis of cervical artery dissection following a recent chiropractic manipulation. Relevant imaging studies were reviewed by a board-certified neuroradiologist to confirm the findings of a cervical artery dissection and stroke. We conducted telephone interviews to ascertain the presence of residual symptoms in the affected patients.
Of the 141 patients with cervical artery dissection, 12 had documented chiropractic neck manipulation prior to the onset of the symptoms that led to medical presentation. The 12 patients had a total of 16 cervical artery dissections. All 12 patients developed symptoms of acute stroke. All strokes were confirmed with magnetic resonance imaging or computerized tomography. We obtained follow-up information on 9 patients, 8 of whom had residual symptoms and one of whom died as a result of his injury.
In this case series, 12 patients with newly diagnosed cervical artery dissection(s) had recent chiropractic neck manipulation. Patients who are considering chiropractic cervical manipulation should be informed of the potential risk and be advised to seek immediate medical attention should they develop symptoms.
本研究的目的是确定在单一机构就诊的、被诊断为与整脊颈部手法治疗相关的颈动脉夹层的患者的发生率。
我们通过对2008年4月至2012年3月期间就诊的患者进行回顾性病历审查来确定病例，这些患者在近期接受整脊手法治疗后被诊断为颈动脉夹层。由一名获得董事会认证的神经放射科医生对相关影像学研究进行审查，以确认颈动脉夹层和中风的诊断结果。我们进行电话访谈以确定受影响患者中残留症状的存在情况。
在141例颈动脉夹层患者中，有12例在导致就医的症状发作前有整脊颈部手法治疗的记录。这12例患者共有16处颈动脉夹层。所有12例患者均出现急性中风症状。所有中风均通过磁共振成像或计算机断层扫描得以确诊。我们获得了9例患者的随访信息，其中8例有残留症状，1例因伤死亡。
在这个病例系列中，12例新诊断为颈动脉夹层的患者近期接受了整脊颈部手法治疗。考虑接受整脊颈部手法治疗的患者应被告知潜在风险，并被建议如果出现症状应立即寻求医疗救治。
