Non-cerebrovascular complications accompanying chiropractic manipulation of the cervical spine.

Purpose: Chirotherapy is a popular and successful management option far rev ersible functional disorders of the cervical spine. Though rarely observed, complications do occur, mainly involving the cerebrovascular system. By me ans of the here described case and a literature survey, we aim to highlight non-cerebrovascular complications of chirotherapeutic cervical spine manip ulation. Results: A 43-year-old mate initially consulted an ENT specialist, suffering from tinnitus aurium and loss of hearing ability. His hearing si gnificantly increased after intravenous drug therapy, but the tinnitus rema ined. During chiropractic manipulation of the cervical spine by an orthopae dic surgeon for the tinnitus, the patient described severe neck pain follow ing a clearly audible clicking sound. Scans of the cervical spine prior to and after manipulation showed an intracapsular/intraosseus oedema of the fa cet joints C2/C3 with lesion of the nerve root C3, most probably induced by chirotherapy. Conclusion: Although complications after chiropractic manipu lation are extremely rare, treatment of the spine, especially the cervical spine, is not wholly harmless. An adequate history taking followed by clini cal and radiographic patient evaluation is necessary to keep the risk of ia trogenic trauma at a minimum. Above all, the chiropractic manipulation of t he cervical spine belongs in the hands of a qualified and experienced medic al practitioner.