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Quadraparesis following Chiropractic Manipulation: A Case Report | OMICS International | Abstract
ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

Quadraparesis following Chiropractic Manipulation: A Case Report

Behnoosh Tabloie1 and Arun Aggarwal2*
1Rehabilitation Registrar, Balmain Hospital, Balmain, NSW, Australia 2041
2Clinical Associate Professor, Department of Rehabilitation Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia 2050
Corresponding Author : Arun Aggarwal
Department of Rehabilitation Medicine
Royal Prince Alfred Hospital
Camperdown, NSW, Australia 2050
Tel: +61 2 9515 9815
Fax: +61 2 9817 6633
E-mail: [email protected]
Received April 09, 2012; Accepted April 18, 2012; Published April 30, 2012
Citation: Tabloie B, Aggarwal A (2012) Quadraparesis following Chiropractic Manipulation: A Case Report. J Clin Case Rep 2:137. doi:10.4172/2165-7920.1000137
Copyright: © 2012 Tabloie B, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Chiropractic manipulation is a popular form of alternative therapy used in the treatment of acute and chronic pain. Neurological complications are uncommon, occurring in 1 per million cervical manipulations. We report a case of a 35-year old man who developed a C3/C4 quadraparesis, shortly after chiropractic manipulation to his neck for acute on chronic neck pain. A CT scan of his cervical spine showed a large central disc protrusion at C3/4 causing severe cord compression and underwent urgent C3/4 cervical decompression with fusion. He improved neurologically and after a period of inpatient rehabilitation he has discharged home, 3 weeks after presentation, independent in mobility and self care with minimal residual upper limb weakness, which resolved over the next few months. Even though neurological complications of spinal manipulation are well recognised, our case demonstrates the
dangers of this popular form of alternative therapy that is generally seen to be benign.
Lessons: Chiropractic manipulation is a popular form of alternative therapy used in the treatment of acute and chronic pain and neurological complications are uncommon, occurring in 1 per million cervical manipulations. Even though neurological complications of spinal manipulation are well recognised, our case demonstrates the dangers of a therapy that is generally seen to be benign.
If the complication is identified as a neurological emergency, excellent functional recovery occurs.
This case highlights the potential pitfalls of this form of treatment and the need for more strict medical control to minimise the risk of complications, especially at the cervical level.
Introduction: Chiropractic spinal manipulation involves a high-velocity thrust to rapidly adjust joints and correct spinal misalignment and relieve pressure on nerves to allow them to function. Neurological complications of cervical manipulations are considered rare, occurring in 1 per million cervical
manipulations [1]. Most complications reported of this therapy are case reports of vertebral artery dissection [2], disc herniation [3] and cervical fracture [4], but there have been reports of Brown-Sequard syndrome due to cord contusion [5], acute paraplegia due to ischaemia [6] and hemiplegia due to a spinal epidural haematoma [7]. Even though neurological complications of spinal manipulation are well recognized [8,9] our case demonstrates the dangers of this popular form of alternative therapy.

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