Acute paraplegia following chiropractic therapy.
We report a 44-year-old man suffering complete paraplegia due to paraspinal and epidural abscess, following chiropractic therapy for severe back pain and whose diagnosis was delayed. He received an immediate laminectomy from T3 through T6 to decompress the full extent of the abscess and appropriate antibiotic therapy for 4 weeks postoperatively for the identified microorganism (Staphylococcus aureus). After 3 months of rehabilitation, he had recovered bladder function with moderate left lower extremity paresis. We emphasise the importance of urgent spinal gadolinium-enhanced MRI in those patients with localised back pain and raised inflammatory markers (including erythrocyte sedimentation rate). Furthermore, it is necessary to be aware of the risk of acute paraplegia after forceful massage to the back.
Wang
Che-Chuan
CC
Department of Neurosurgery, Chi-Mei Medical Center, 901 Chung Hwa Road, Yung Kang City, Tainan 710, Taiwan.
Kuo
Jinn-Rung
JR
Chio
Chung-Ching
CC
Tsai
Tsung-Chia
TC
D000208:Acute Disease; D000328:Adult; D020802:Epidural Abscess / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D026882:Manipulation, Chiropractic / Q000009:adverse effects*; D010264:Paraplegia / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000382:microbiology; D011859:Radiography; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging