Neurological complications of cervical spine manipulation

To obtain preliminary data on neurological complications of spinal manipula tion in the UK all members of the Association of British Neurologists were asked to report cases referred to them of neurological complications occurr ing within 24 hours of cervical spine manipulation over a 12-month period. The response rate was 74%. 24 respondents reported at least one case each, contributing to a total of about 35 cases. These included 7 cases of stroke in brainstem territory (4 with confirmation of vertebral artery dissection ), 2 cases of stroke in carotid territory and 1 case of acute subdural haem atoma. There were 3 cases of myelopathy and 3 of cervical radiculopathy. Concern about neurological complications following cervical spine manipulat ion appears to be justified. A large long-term prospective study is require d to determine the scale of the hazard.