Nair Vishnu Vikraman, Kundnani Vishal, Anand Manikant, Shetty Abhijith, Jain Mukul, Chodavadiya Sunil Shamjibhai
Department of Orthopaedics and Spine Surgery, Bombay Hospital and Medical Research Institute, Mumbai, Maharashtra, India.
J Orthop Case Rep. 2022 Nov;12(11):50-53. doi: 10.13107/jocr.2022.v12.i11.3412.
In this case report, we question the safety associated with high velocity manipulations of the cervical spine. These procedures do not frequently cause catastrophic adverse effects but few and rare case reports like this make us aware about the possible complications of the maneuvers.
This case report presents an uncommon presentation of acute neurodeficit to a 57-year-old male following a neck manipulation by a barber in the saloon which recovered partially with Intravenous steroid therapy but required active intervention surgically to treat his complete symptomatology. The magnetic resonance imaging (T2-weighted) showed a high signal intensity within the spinal cord at the C4C5 level (cord edema). Here, we discuss the possible mechanism of injury and the need to educate the lesser common risks of performing such sudden and forceful maneuvers.
This case report is a reminder that people should be careful while trying alterative types of therapy which use forceful neck manipulations to relieve pain as this maneuver could cause injuries to the disc complex especially when the patient already has a disc prolapse which is asymptomatic, causing the disc to fail again making it symptomatic.
在本病例报告中,我们对颈椎高速手法操作的安全性提出质疑。这些操作并不常导致灾难性不良反应,但像这样极少且罕见的病例报告让我们意识到这些手法可能存在的并发症。
本病例报告呈现了一名57岁男性在理发店接受颈部手法操作后出现急性神经功能缺损的罕见情况。经静脉类固醇治疗后部分恢复,但需要手术积极干预以治疗其全部症状。磁共振成像(T2加权)显示C4C5水平脊髓内高信号强度(脊髓水肿)。在此,我们讨论了可能的损伤机制以及教育人们了解进行此类突然且强力手法操作的罕见风险的必要性。
本病例报告提醒人们,在尝试使用强力颈部手法操作来缓解疼痛的替代疗法时应谨慎,因为这种手法可能会损伤椎间盘复合体,尤其是当患者已有无症状的椎间盘突出时,会导致椎间盘再次受损并出现症状。