title: [Retrospective analysis and prevention strategies for accidents associated with cervical manipulation in China].
abstract: OBJECTIVE
  To review previously reported injuries cases which were associated with cervical manipulation in China, and to describe the risks and benefits of the therapy.
  
  
  METHODS
  Relevant case reports, review articles, surveys, and investigations regarding treatment of cervical spondylosis with cervical manipulation involving accidents and associated complication were retrived with a search of the literature from SinoMed, CNKI, CQVIP, and Wanfang digital databases between 1979 to March 2011. The data were extracted and statistically analyzed.
  
  
  RESULTS
  Total of 150 cases of injury reported in 40 articles corresponded the inclusion criteria. Accidents occurred in 156 cases,of them,syncope was in 45 cases (28.85%), mild spinal cord injury or compression was in 34 cases (21.79%), nerve root injury was in 24 cases (15.38%), ineffective or symptom increased was in 11 cases (7.05%); cervical spine fracture was in 11 cases (7.05%), dislocation or semiluxation was in 6 cases (3.85%), soft tissue injury was in 3 cases (1.92%), serious accident was 22 cases (14.70%, including paralysis, death and cerebrovascular accident). In cases of serious accident, 12 cases (54.55%) had the other primary diseases. Types of related manipulation including rotation reduction (42.00%, 63 cases), rubbing points or muscle resulting strong stimulation (28.00%, 42 cases). 100 cases (66.67%) obtained cured or basically recovered results, 21 cases (14.00%) improved, 4 cases (2.67%) deterioration and 5 cases (3.33%) died.
  
  
  CONCLUSIONS
  It is imperative for practitioners to complete the patients' management and assessment before manipulation. That the practitioners conduct a detailed physical examination and make a correct diagnosis would be a pivot method of avoiding accidents. Excluding contraindications and potential risks, standardizing evaluation criteria and practitioners' qualification, increasing safety awareness and risk assessment and strengthening the monitoring of the accidents could decrease the incidence of accidents.
authors.affiliation: Shi's Center of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology and Orthopaedics, Shanghai Academy of TCM, Shanghai 201203, China.
authors.forename: Hui-Hao
authors.initials: HH
authors.lastname: Wang
authors.forename: Hong-Sheng
authors.initials: HS
authors.lastname: Zhan
authors.forename: Ming-Cai
authors.initials: MC
authors.lastname: Zhang
authors.forename: Bo
authors.initials: B
authors.lastname: Chen
authors.forename: Kai
authors.initials: K
authors.lastname: Guo
mesh_terms: D000059:Accidents; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D020393:Manipulation, Spinal / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D018570:Risk Assessment