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Letters |15 April 1993

Osteopathy, Chiropractic, and Spinal Manipulation

Michael A. Patmas, MD

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TO THE EDITOR:
Shekelle and colleagues [1] suggest that the risk of spinal manipulation is low because they could only identify nine reports of manipulation-related complications. In 1985, I identified 33 separate reports of various injuries caused by chiropractic spinal manipulation (Table 1).
Over a 3-year period in a general medical practice, Livingston [2] examined 676 patients with back pain. Of these, 172 (25%) had seen a chiropractor previously, and 12 (7%) had received some sort of injury, primarily to soft tissue. Of greater concern are the more than 40 reported cases of brain or spinal cord infarction associated with chiropractic manipulation [3]. In 1981, the Members of the Stroke Council of the American Heart Association were surveyed and related 360 cases of stroke associated with manipulation [4]. Before spinal manipulation can be generally recommended, studies specifically addressing these risks are needed.
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Patmas MA. Osteopathy, Chiropractic, and Spinal Manipulation. Ann Intern Med. 1993;118:651–653. doi: 10.7326/0003-4819-118-8-199304150-00030

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Published: Ann Intern Med. 1993;118(8):651-653.

DOI: 10.7326/0003-4819-118-8-199304150-00030

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