Acute Paraparesis in a Patient after High Velocity Manipulation of Cervical Spine and its Management
Structural and chiropractic
J Orthop Case Rep.2022 Nov;12(11):50-53
Vishnu Vikraman Nair, Vishal Kundnani, Manikant Anand, Abhijith Shetty, Mukul Jain, Sunil Shamjibhai Chodavadiya
Introduction: In this case report, we question the safety associated with high velocity manipulations of the cervical spine. These procedures do not frequently cause catastrophic adverse effects but few and rare case reports like this make us aware about the possible complications of the maneuvers. Case report: This case report presents an uncommon presentation of acute neurodeficit to a 57-year-old male following a neck manipulation by a barber in the saloon which recovered partially with Intravenous steroid therapy but required active intervention surgically to treat his complete symptomatology. The magnetic resonance imaging (T2-weighted) showed a high signal intensity within the spinal cord at the C4C5 level (cord edema). Here, we discuss the possible mechanism of injury and the need to educate the lesser common risks of performing such sudden and forceful maneuvers. Conclusion: This case report is a reminder that people should be careful while trying alterative types of therapy which use forceful neck manipulations to relieve pain as this maneuver could cause injuries to the disc complex especially when the patient already has a disc prolapse which is asymptomatic, causing the disc to fail again making it symptomatic.