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Misuse of the Literature by Medical Authors in Discussing Spinal Manipulative Therapy Injury

Chiro.Org Blog: In 1995 Dr. Allan Terrett, Associate Professor of Clinical Orthopaedics and Clinical Neurology at RMITU’s Division of Chiropractic Studies, had a paper published [1] in JMPT wherein he documented various levels at which the title chiropractor was being misused. I (meaning the author Adrian B Wenban) recently had a review published [2] that is very much built on Terrett’s work from the 90’s and that further documents the continued inappropriate use of the title chiropractor and term chiropractic manipulation by biomedical researchers from specific countries. […]

The Etiology of Cervical Artery Dissection

Chiro.Org Blog: The etiology of cervical artery dissection (CAD) is unclear, although a number of risk factors have been reported to be associated with the condition. On rare occasions, patients experience CAD after cervical spine manipulation, making knowledge about the cervical arteries, the predisposing factors, and the pathogenesis of the condition of interest to chiropractors. This commentary reports on the relevant anatomy of the cervical arteries, developmental features of CAD, epidemiology of the condition, and mechanisms of dissection. […]

Recognition of Spontaneous Vertebral Artery Dissection

Chiro.Org Blog: This case highlights the potential for patients with vertebral artery dissection to present with nonspecific musculoskeletal complaints. Neurological symptoms may not manifest initially, but their sudden onset indicates the possibility of an ischemic cerebrovascular event. We suggest that early recognition and emergent referral for this patient avoided potential exacerbation of an evolving pre-existing condition and resulted in timely anticoagulation treatment. […]

Elongated Styloid Processes and Calcified Stylohyoid Ligaments in a Patient With Neck Pain: Implications for Manual Therapy Practice

Chiro.Org Blog: Neck pain in the presence of elongated styloid processes (ESPs) and calcified stylohyoid ligaments (CSLs) can be associated with Eagle syndrome, which can include ipsilateral head and neck pain, odynophagia, dysphagia, and cerebrovascular symptoms. This case, initially thought to be Eagle syndrome, highlights proper diagnostic workup for this condition and presents potential contraindications to consider with regard to cervical spine manipulation in such patients. Manual therapy precautions pertaining to cervical spine manipulation may be appropriate in cases involving ESPs and calcified stylohyoid ligaments. […]

Vertebral Artery Dissection in a Patient Practicing Self-manipulation of the Neck

Chiro.Org Blog: The purpose of this case report is to describe a patient who regularly practiced self-manipulation of her neck who presented with shoulder and neck pain and was undergoing a vertebral artery dissection. […]

Changes in Vertebral Artery Blood Flow Following Various Head Positions and Cervical Spine Manipulation

This pilot study was conducted as a blinded examiner cohort with 4 randomized clinical tasks. Ten healthy male participants aged 24 to 30 years (mean, 26.8 years) volunteered to participate in the study. None of the participants had a history of disabling neck, arm, or headache pain within the last 6 months. They did not have any current or history of neurologic symptoms. In a neutral head position, physiologic measures of VA blood flow and velocity at the C1-2 spinal level were obtained using phase-contrast magnetic resonance imaging after 3 different head positions and a chiropractic upper cervical spinal manipulation. A total of 30 flow-encoded phase-contrast images were collected over the cardiac cycle, in each of the 4 conditions, and were used to provide a blood flow profile for one complete cardiac cycle. Differences between flow (in milliliters per second) and velocity (in centimeters per second) variables were evaluated using repeated-measures analysis of variance. […]