title: Trauma-induced pneumothorax after "bear-hug back crack" home remedy: attempted spinal manipulation by a layperson.
abstract: Spinal manipulation, as practiced by US-trained osteopathic physicians, is a safe and effective method of resolving patient pain and encouraging desirable physiologic improvement--often without pharmacologic intervention. Though novices, laypeople, and other clinicians also use manual techniques with similar goals in mind, their results are varied and sometimes dangerous to those they would help. The authors describe a case in which a layperson attempted spinal manipulation on a 20-year-old woman who later required a chest tube thoracostomy and hospitalization as a result of a pneumothorax. Osteopathic physicians are encouraged to consider patient risk factors for pneumothorax as a contraindication for the use of thoracic thrust techniques.
authors.affiliation: Department of Emergency Medicine, Carl R. Darnall Army Medical Center, 36000 Darnall Loop, Fort Hood, TX 76544-5095, USA. david.masneri@amedd.army.mil
authors.forename: David A
authors.initials: DA
authors.lastname: Masneri
authors.forename: Jeremy S
authors.initials: JS
authors.lastname: Helphenstine
authors.forename: Shannon M
authors.initials: SM
authors.lastname: Masneri
authors.forename: Michael A
authors.initials: MA
authors.lastname: Miller
authors.forename: Marc E
authors.initials: ME
authors.lastname: Levsky
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D020393:Manipulation, Spinal / Q000009:adverse effects*; D011030:Pneumothorax / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013902:Radiography, Thoracic; D013898:Thoracic Injuries / Q000150:complications* / Q000175:diagnosis; D013907:Thoracostomy / Q000379:methods; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000175:diagnosis