[Complications following vertebral manipulation-a survey of a French region physicians].
BACKGROUND
Recent studies have emphasized the incidence and the general underestimation in literature of spinal manipulation (SM) linked accident. The aim of this study was to estimate the frequency and the incidence of strokes, myelopathies, radiculopathies or osteoarticular accidents in a major French area.


METHODS
We made a survey among 240 neurologists, neurosurgeons, rhumatologists and physicians concerning the number of accidents observed during the preceding two years.


RESULTS
We obtained a response from 133 physicians and 93 cases of complication were reported. Most of these complications were radiculopathies (69%). Approximatively 50% occurred at the cervical level, less than 24 hours after SM with or without sligth aftereffects in 68%. The incidence of vertebro-basilar accidents was 30 times higher than in published series.


CONCLUSIONS
Spinal manipulations should remain under very strict medical control. Physicians who practice SM should be able to choose the manual treatment and perform it themselves in order to minimize risks of complications, especially at the cervical level.
Dupeyron
A
A
Service de médecine physique et réadaptation, hôpitaux universitaires, avenue Molière, 67000, Strasbourg, France. Arnaud.Dupeyron@chru-strasbourg.fr <Arnaud.Dupeyron@chru-strasbourg.fr>
Vautravers
Ph
P
Lecocq
J
J
Isner-Horobeti
M E
ME
D000328:Adult; D000367:Age Factors; D000368:Aged; D020968:Brachial Plexus Neuritis / Q000209:etiology*; D002340:Carotid Artery Diseases / Q000209:etiology; D002648:Child; D003625:Data Collection; D005602:France; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology; D026882:Manipulation, Chiropractic / Q000009:adverse effects*; D020393:Manipulation, Spinal / Q000009:adverse effects*; D010021:Osteopathic Medicine; D011128:Polyradiculopathy / Q000209:etiology*; D011843:Radiculopathy / Q000209:etiology*; D012253:Rib Fractures / Q000209:etiology; D012307:Risk Factors; D013118:Spinal Cord Diseases / Q000209:etiology*; D016103:Spinal Fractures / Q000209:etiology; D013124:Spinal Injuries / Q000209:etiology*; D020521:Stroke / Q000209:etiology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014715:Vertebrobasilar Insufficiency / Q000209:etiology