On 18/7/2022 the ‘WORLD FEDERATION OF CHIROPRACTIC’ published a statement on cervical artery dissection (CAD). Below are a few excerpts to which I have added a few numbers [in brackets] which refer to my comments below:
… On rare occasions, CAD has been reported to have occurred after a patient visited a chiropractor or other provider of manual therapy [1]. However, the best evidence available to date indicates that spinal manipulation does not stress the arteries enough to cause tearing of the arteries leading to dissection-related strokes [2]. Additional studies have concluded that patients are as likely to have consulted a primary care physician as receive spinal manipulation from a chiropractor prior to experiencing a CAD-related stroke [3]…
The provision of safe, high-quality, evidence-based, patient-centered care for these and other conditions is a priority for the chiropractic profession [4]. Rigorous research is core to the pursuit of that objective [5]. We urge caution in making claims that are in conflict with the current state of the evidence.
About the WFC
The World Federation of Chiropractic is an international, non-governmental organization whose members are the national associations of over 90 countries in seven world regions. It is a non-state actor in official relations with the World Health Organization and is the global authority for matters related to the chiropractic profession [6]…
Cassidy JD, Boyle E, Côté P, He Y, Hogg-Johnson S, Silver FL, Bondy SJ. Risk of Vertebrobasilar Stroke and Chiropractic Care: Results of a Population-Based Case-Control and Case-Crossover Study. Eur Spine J. 2008 Apr;17(Suppl 1):176–83. Open access here.#
Chaibi A, Russell MB. A risk-benefit assessment strategy to exclude cervical artery dissection in spinal manual-therapy: a comprehensive review. Ann Med. 2019 Mar;51(2):118-127. Open access here.
Church EW, Sieg EP, Zalatimo O, Hussain NS, Glantz M, Harbaugh RE. Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation. Cureus. 2016 Feb 16;8(2):e498. Open access here.
Kosloff TM, Elton D, Tao J, Bannister WM. Chiropractic care and the risk of vertebrobasilar stroke: results of a case-control study in U.S. commercial and Medicare Advantage populations. Chiropr Man Therap. 2015 Jun 16;23:19. Open access here.
Rubinstein SM, Peerdeman SM, van Tulder MW, Riphagen I, Haldeman S. A systematic review of the risk factors for cervical artery dissection. Stroke. 2005 Jul;36(7):1575-80. Open access here.
Whedon JM, Mackenzie TA, Phillips RB, Lurie JD. Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66 to 99 years. Spine (Phila Pa 1976). 2015 Feb 15;40(4):264-70. Open access here
Here are my brief comments based on the evidence discussed in dozens of posts previously published on this blog:
This content was originally published here.
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