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Rehabilitation Practice and Science

Translated Title

頸椎徒手推拿後併發頸椎椎間盤突出及脊髓病變

Abstract

Complications following cervical manipulation can be classified as cerebrovascular or noncerebrovascular complications. The former complications occur more frequently, and they are usually due to vertebral artery occlusion, damage or thrombus formation. The latter include spinal cord or nerve root injuries and have seldom been reported. Herniation of the cervical disc with myelopathy following manipulation is rare. However, we have encountered two patients who developed cervical disc herniation with myelopathy secondary to cervical tuina manipulation for nuchalgia at the bone setting facilities. One of the patients suffered from shooting pain during manipulation and developed tetraparesis two days later. An MRI examination revealed herniation of the intervertebral disc at the C4-5 level. Another patient suffered from right hemiplegia immediately after manipulation and was initially diagnosed with a cerebrovascular accident. Tetraplegia developed a few days later and an MRI study demonstrated herniation of the intervertebral disc at the C3-4 and C4-5 levels with prominent cord compression. Both patients underwent cervical discectomy with bone fusion and received rehabilitation therapy after the operation. They satisfactorily improved and could ambulate with a nearly normal gait without requiring an assistive device. The risk of cervical disc herniation with myelopathy following cervical manipulation cannot be overemphasized because an early diagnosis and timely intervention are vital. While skillful techniques and appropriate force need to be applied to the neck during manipulation, the same care must be taken to reduce the risk of complications following manipulation.

Language

English

First Page

111

Last Page

119

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