Kewalramani L S, Kewalramani D L, Krebs M, Saleem A
Am J Phys Med. 1982 Aug;61(4):165-75.
Manipulation of the spine, a controversial mechanotherapeutic procedure, has been taught and practiced widely. Occlusion of vertebral, basillar, and cerebellar arteries with head and neck manipulation is well documented in the literature. However, there is a paucity of references about myelopathy associated with cervical spine manipulation. Three cases of cervical myelopathy following spinal manipulation are presented. All patients noted increase in cervical pain following manipulation, developed significant sensary/motor deficits within 24 hours and became tetraparetic. Two patients were found to have fracture of C5 and C6 vertebral bodies. On myelography, partial block was noted in all and widening of the spinal cord was noted in two. One patient underwent excision of C5 vertebral body and anterior interbody fusion C4/6. Two patients underwent cervical laminectomy. Hematomyelia was present in one, and in the other patient the spinal cord was reported to be hyperemic and oedematous. Only one patient showed neurological return and became ambulatory, while the other two remained tetraparetic.
脊柱推拿是一种存在争议的机械治疗方法，已得到广泛传授和应用。文献中已有充分记载，头部和颈部推拿会导致椎动脉、基底动脉和小脑动脉闭塞。然而，关于颈椎推拿相关脊髓病的参考文献却很少。本文报告了3例脊柱推拿后发生颈椎脊髓病的病例。所有患者在推拿后颈部疼痛均加重，在24小时内出现明显的感觉/运动功能障碍，并发展为四肢轻瘫。两名患者被发现存在C5和C6椎体骨折。脊髓造影显示，所有患者均有部分梗阻，两名患者脊髓增宽。一名患者接受了C5椎体切除及C4/6前路椎间融合术。两名患者接受了颈椎椎板切除术。一名患者出现脊髓内出血，另一名患者的脊髓据报告有充血和水肿。只有一名患者神经功能恢复并能行走，而另外两名患者仍为四肢轻瘫。
