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Acute Spinal Epidural Haematoma Causing Cord Compression After Chiropractic Neck Manipulation: An Under-recognised Serious Hazard?
  1. Mr Surjit Lidder1,
  2. KJ Lang, Foundation trainee in General Medicine,
  3. S Masterson, Specialist Registrar in Trauma and Orthopaedics3 and
  4. S Blagg, Consultant Orthopaedic Surgeon4
  1. 1ST3 in Trauma and Orthopaedics, Royal London Hospital, Whitechapel Road, London, UK 020 7377 7000 surjitlidder{at}doctors.org.uk
  2. 3Royal London Hospital, Whitechapel Road, London
  3. 4Stoke Mandeville Hospital Mandeville Road, Aylesbury, Bucks

Abstract

Spinal manipulative therapy performed by chiropractors is increasingly common in the United Kingdom. Spinal epidural haematoma is a rare complication of such physical therapy but when identified represents a neurological emergency. We describe the case of a 64 year-old man who presented with a dense hemiplegia due to a spinal epidural haematoma following cervical spine manipulation performed for acute neck pain. The clinical features and surgical management of the case are discussed and we stress the importance of recognition of chiropractic manipulation as a potential cause of neurological sequelae and discuss the potential pitfalls of such therapy as it becomes more widespread.

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