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Huang M, Barber SM, Moisi M, et al. Cervical Epidural Hematoma after Chiropractic Spinal Manipulation Therapy in a Patient with an Undiagnosed Cervical Spinal Arteriovenous Malformation. Cureus. 2015;7(8):e307doi: 10.7759/cureus.307.
Huang, M., Barber, S. M., Moisi, M., Powell, S., Rivera, A., Zwillman, M., & Rose, J. (2015). Cervical Epidural Hematoma after Chiropractic Spinal Manipulation Therapy in a Patient with an Undiagnosed Cervical Spinal Arteriovenous Malformation. Cureus, 7(8), e307. https://doi.org/10.7759/cureus.307
Huang, Meng, et al. "Cervical Epidural Hematoma after Chiropractic Spinal Manipulation Therapy in a Patient with an Undiagnosed Cervical Spinal Arteriovenous Malformation." Cureus vol. 7,8 (2015): e307. doi: https://doi.org/10.7759/cureus.307
Huang M, Barber SM, Moisi M, Powell S, Rivera A, Zwillman M, Rose J. Cervical Epidural Hematoma after Chiropractic Spinal Manipulation Therapy in a Patient with an Undiagnosed Cervical Spinal Arteriovenous Malformation. Cureus. 2015 Aug 18;7(8):e307. doi: 10.7759/cureus.307. PMID: 26430581; PMCID: PMC4578713.
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Cureus. 2015 Aug 18;7(8):e307. doi: 10.7759/cureus.307.

Cervical Epidural Hematoma after Chiropractic Spinal Manipulation Therapy in a Patient with an Undiagnosed Cervical Spinal Arteriovenous Malformation.

Cureus

Meng Huang, Sean M Barber, Marc Moisi, Suzanne Powell, Andreana Rivera, Michael Zwillman, James Rose

Affiliations

  1. Department of Neurogurgery, Houston Methodist Neurological Institute.
  2. Neurosurgery, Swedish Neuroscience Institute.
  3. Department of Pathology and Laboratory Medicine, Houston Methodist Hospital.
  4. Anesthesia and Critical Care, Houston Methodist Hospital.
  5. Department of Neurosurgery, University Medical Center Brackenridge.

PMID: 26430581 PMCID: PMC4578713 DOI: 10.7759/cureus.307

Abstract

Spinal epidural hematoma (SEH) occurring after chiropractic spinal manipulation therapy (CSMT) is a rare clinical phenomenon. Our case is unique because the patient had an undiagnosed cervical spinal arteriovenous malformation (AVM) discovered on pathological analysis of the evacuated hematoma. Although the spinal manipulation likely contributed to the rupture of the AVM, there was no radiographic evidence of the use of excessive force, which was seen in another reported case. As such, patients with a known AVM who have not undergone surgical intervention should be cautioned against symptomatic treatment with CSMT, even if performed properly. Regardless of etiology, SEH is a surgical emergency and its favorable neurological recovery correlates inversely with time to surgical evacuation.

Keywords: chiropractic manipulation; spinal arteriovenous malformation; spinal epidural hematoma

References

  1. J Neurosurg. 1988 May;68(5):798-801 - PubMed
  2. J Trauma. 2002 Mar;52(3):585-6 - PubMed
  3. Neurosurgery. 2007 Jul;61(1):E170-1; discussion E171 - PubMed
  4. Neurosurgery. 1989 Mar;24(3):410-4 - PubMed
  5. J R Soc Med. 2007 Jul;100(7):330-8 - PubMed
  6. J Bone Joint Surg Am. 2001 Feb;83-A(2):255-8 - PubMed
  7. Pediatr Neurol. 1998 Oct;19(4):302-7 - PubMed
  8. Neurology. 1978 Mar;28(3):224-8 - PubMed
  9. Z Orthop Ihre Grenzgeb. 2004 Jan-Feb;142(1):79-82 - PubMed
  10. Z Orthop Ihre Grenzgeb. 2004 Sep-Oct;142(5):631-2 - PubMed
  11. Am J Emerg Med. 2009 Oct;27(8):1023.e1-2 - PubMed
  12. J Neurosurg. 1995 Jul;83(1):1-7 - PubMed
  13. Neurosurgery. 1996 Nov;39(5):1043-5 - PubMed
  14. J Korean Med Sci. 2005 Apr;20(2):331-4 - PubMed
  15. J Neurosurg Spine. 2007 Nov;7(5):571-4 - PubMed
  16. J R Army Med Corps. 2010 Dec;156(4):255-7 - PubMed
  17. Dev Med Child Neurol. 2004 Dec;46(12):838-42 - PubMed
  18. J Comput Assist Tomogr. 1999 Mar-Apr;23(2):238-43 - PubMed
  19. J Spinal Disord. 1991 Jun;4(2):234-7 - PubMed
  20. Phys Ther. 1999 Jan;79(1):50-65 - PubMed
  21. J Manipulative Physiol Ther. 2006 Sep;29(7):582-5 - PubMed

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