Safety of spinal manipulation in the treatment of lumbar disk herniations: A systematic review and risk assessment

被引:80
作者
Oliphant, D [1 ]
机构
[1] Comfort Hlth, Calgary, AB T2G 0A6, Canada
关键词
chiropractic manipulation; intervertebral disc herniation; cauda equina syndrome; low back pain; safety; adverse reactions;
D O I
10.1016/j.jmpt.2003.12.023
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective: To provide a qualitative systematic review of the risk of spinal manipulation in the treatment of lumbar disk herniations (LDH) and to estimate the risk of spinal manipulation causing a severe adverse reaction in a patient presenting with LDH. Data Sources: Relevant case reports, review articles, surveys, and investigations regarding treatment of lumbar disk herniations with spinal manipulation and adverse effects and associated risks were found with a search of the literature. Data Synthesis: Prospective/retrospective studies and review papers were graded according to quality, and results and conclusions were tabulated. From the data published, an estimate of the risk of spinal manipulation causing a clinically worsened disk herniation or cauda equina syndrome (CES) in patients presenting with LDH was calculated. This was compared with estimates of the safety of nonsteroidal anti-inflammatory drugs (NSAIDs) and surgery in the treatment of LDH. Results: An estimate of the risk of spinal manipulation causing a clinically worsened disk herniation or CES in a patient presenting with LDH is calculated from published data to be less than 1 in 3.7 million. Conclusion: The apparent safety of spinal manipulation, especially when compared with other accepted treatments for LDH, should stimulate its increased use in the conservative treatment plan of LDH.
引用
收藏
页码:197 / 210
页数:14
相关论文
共 73 条
[1]
GRADUAL DISK PROLAPSE [J].
ADAMS, MA ;
HUTTON, WC .
SPINE, 1985, 10 (06) :524-531
[2]
THE STAGES OF DISK DEGENERATION AS REVEALED BY DISCOGRAMS [J].
ADAMS, MA ;
DOLAN, P ;
HUTTON, WC .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1986, 68 (01) :36-41
[3]
ANDERSSON G, 1997, ADULT SPINE PRINCIPA
[4]
Assendelft WJJ, 1996, J FAM PRACTICE, V42, P475
[5]
Adverse effects of spinal manipulation [J].
Barrett, AJ ;
Breen, AC .
JOURNAL OF THE ROYAL SOCIETY OF MEDICINE, 2000, 93 (05) :258-259
[6]
BENELIYAHU DJ, 1996, J MANIP PHYSIOL THER, V19, P55
[7]
Bergmann TF, 1998, J MANIP PHYSIOL THER, V21, P288
[8]
Classics in Spine - Surgery literature revisited [J].
Bessette, L ;
Liang, MH ;
Lew, RA ;
Weinstein, JN .
SPINE, 1996, 21 (03) :259-263
[9]
Bjorkman David J., 1999, American Journal of Medicine, V107, p3S
[10]
BOGDUK N, 1990, J MANUAL MED, V5, P72