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Thoracic Disk Herniation Associated With Chiropractic Spinal Manipulation

Thoracic Disk Herniation Associated With Chiropractic Spinal Manipulation Abstract To the Editor. —Chiropractic spinal manipulation has been associated with numerous neurologic complications, including brain-stem infarction,1 cervical spinal cord injury,2 and cauda equina syndrome.3-5 We describe a case of thoracic intervertebral disk herniation with resultant myelopathy following spinal manipulation. Report of a Case. —This previously healthy 55-year-old man visited a chiropractor with a complaint of low back pain. Aggressive rotatory and hyperextensional manipulation of the entire spine was performed, immediately following which he noted the onset of numbness and paresthesias in both feet. His sensory complaints progressed and, five days later, he presented with bandlike pain in the upper thoracic region and increased numbness to approximately the level of the umbilicus. Physical examination showed mild left leg weakness and a wide-based, unsteady gait. Deep-tendon reflexes in the lower extremities were brisk and symmetric. Babinski's sign was present on the left side and equivocal on the right side. References 1. Mueller S, Sahs AL: Brain-stem dysfunction related to cervical manipulation . Neurology 1976;26:547-550.Crossref 2. Rinsky LA, Reynolds GG, Jameson RM, et al: A cervical spinal cord injury following chiropractic manipulation . Paraplegia 1976;13:223-227. 3. Gallinaro P, Cartesegna M: Three cases of lumbar disk rupture and one of cauda equina associated with spinal manipulation (chiropraxis) . Lancet 1983;1:411.Crossref 4. Hooper J: Low back pain and manipulation: Paraparesis after treatment of low back pain by physical methods . Med J Aust 1973;1:549-551. 5. Malmivaara A, Pohjola R: Cauda equina syndrome caused by chiropraxis on a patient previously free of lumbar spine symptoms . Lancet 1982;2:986-987.Crossref 6. Arce CA, Dohrman GJ: Herniated thoracic disks . Neurol Clin 1983;3:383-392. 7. Arseni C, Nash F: Protrusion of thoracic intervertebral discs . Acta Neurochir 1963;11:11-33. 8. Carson J, Gumpert J, Jefferson A: Diagnosis and treatment of thoracic intervertebral disc protrusions . J Neurol Neurosurg Psychiatry 1971;34:68-77.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Thoracic Disk Herniation Associated With Chiropractic Spinal Manipulation

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References (8)

Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1987.00520220006004
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. —Chiropractic spinal manipulation has been associated with numerous neurologic complications, including brain-stem infarction,1 cervical spinal cord injury,2 and cauda equina syndrome.3-5 We describe a case of thoracic intervertebral disk herniation with resultant myelopathy following spinal manipulation. Report of a Case. —This previously healthy 55-year-old man visited a chiropractor with a complaint of low back pain. Aggressive rotatory and hyperextensional manipulation of the entire spine was performed, immediately following which he noted the onset of numbness and paresthesias in both feet. His sensory complaints progressed and, five days later, he presented with bandlike pain in the upper thoracic region and increased numbness to approximately the level of the umbilicus. Physical examination showed mild left leg weakness and a wide-based, unsteady gait. Deep-tendon reflexes in the lower extremities were brisk and symmetric. Babinski's sign was present on the left side and equivocal on the right side. References 1. Mueller S, Sahs AL: Brain-stem dysfunction related to cervical manipulation . Neurology 1976;26:547-550.Crossref 2. Rinsky LA, Reynolds GG, Jameson RM, et al: A cervical spinal cord injury following chiropractic manipulation . Paraplegia 1976;13:223-227. 3. Gallinaro P, Cartesegna M: Three cases of lumbar disk rupture and one of cauda equina associated with spinal manipulation (chiropraxis) . Lancet 1983;1:411.Crossref 4. Hooper J: Low back pain and manipulation: Paraparesis after treatment of low back pain by physical methods . Med J Aust 1973;1:549-551. 5. Malmivaara A, Pohjola R: Cauda equina syndrome caused by chiropraxis on a patient previously free of lumbar spine symptoms . Lancet 1982;2:986-987.Crossref 6. Arce CA, Dohrman GJ: Herniated thoracic disks . Neurol Clin 1983;3:383-392. 7. Arseni C, Nash F: Protrusion of thoracic intervertebral discs . Acta Neurochir 1963;11:11-33. 8. Carson J, Gumpert J, Jefferson A: Diagnosis and treatment of thoracic intervertebral disc protrusions . J Neurol Neurosurg Psychiatry 1971;34:68-77.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Oct 1, 1987

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