Journal of Manipulative and Physiological Therapeutics
Volume 27, Issue 9 , Pages 539-546 , November 2004

Defining the Effect of Cervical Manipulation on Vertebral Artery Integrity: Establishment of an Animal Model

  • Gregory N. Kawchuk, DC, PhD

      Affiliations

    • Faculty of Rehabilitation Medicine, University of Alberta, Alberta, Canada
    • Corresponding Author InformationSubmit requests for reprints to: Greg Kawchuk, DC, PhD, Faculty of Rehabilitation Medicine, University of Alberta, 2-28 Corbett Hall, Edmonton, Alberta, Canada T6G 2G4
    • ,
  • Shari Wynd, DC

      Affiliations

    • Graduate Student, University of Calgary, Alberta, Canada
    • ,
  • Todd Anderson, MD

      Affiliations

    • Faculty of Medicine, University of Calgary, Alberta, Canada

Received 19 May 2003

References 

  1. Wood MJ, Lang EK, Woolhandler GJ, Faludi HK. Traumatic vertebral artery thrombosis. J La State Med Soc. 1971;123:413–414
  2. Schellhas KP, Latchaw RE, Wendling LR, Gold LH. Vertebrobasilar injuries following cervical manipulation. JAMA. 1980;244:1450–1453
  3. Hufnagel A, Hammers A, Schonle PW, Bohm KD, Leonhardt G. Stroke following chiropractic manipulation of the cervical spine. J Neurol. 1999;246:683–688
  4. Nadgir RN, Loevner LA, Ahmed T, Moonis G, Chalela J, Slawek K, et al. Simultaneous bilateral internal carotid and vertebral artery dissection following chiropractic manipulation: case report and review of the literature. Neuroradiology. 2003;45:311–314
  5. Mann T, Refshauge KM. Causes of complications from cervical spine manipulation. Aust J Physiother. 2001;47:255–266
  6. Haldeman S, Carey P, Townsend M, Papadopoulos C. Arterial dissections following cervical manipulation: the chiropractic experience. Can Med Assoc J. 2001;165:905–906
  7. Kessler RC, Davis RB, Foster DF, Van Rompay MI, Walters EE, Wilkey SA, et al. Long-term trends in the use of complementary and alternative medical therapies in the United States. Ann Intern Med. 2001;135:262–268
  8. Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, et al. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA. 1998;280:1569–1575
  9. Davidson KC, Weiford EC, Dixon GD. Traumatic vertebral artery pseudoaneurysm following chiropractic manipulation. Radiology. 1975;115:651–652
  10. Parkin PJ, Wallis WE, Wilson JL. Vertebral artery occlusion following manipulation of the neck. N Z Med J. 1978;88:441–443
  11. Zak SM, Carmody RF. Cerebellar infarction from chiropractic neck manipulation: case report and review of the literature. Ariz Med. 1984;41:333–337
  12. Kapral MK, Bondy SJ. Cervical manipulation and risk of stroke. Can Med Assoc J. 2001;165:907–908
  13. Rothwell DM, Bondy SJ, Williams JI. Chiropractic manipulation and stroke: a population-based case-control study. Stroke. 2001;32:1054–1060
  14. Pan G, Wright KC. Clot embolic stroke in the vertebrobasilar system of rabbits: a transfemoral angiographic technique. Cardiovasc Intervent Radiol. 1987;10:285–290
  15. Nakahara T, Oki S, Muttaqin Z, Kuwabara S, Uozumi T. A new model of brainstem ischemia by embolization technique in cats. Neurosurg Rev. 1991;14:221–229
  16. Megyesi JF, Vollrath B, Cook DA, Findlay JM. In vivo animal models of cerebral vasospasm: a review. Neurosurgery. 2000;46:448–460
  17. Marshall LF, Bruce DA, Bruno L, Langfitt TW. Vertebrobasilar spasm: a significant cause of neurological deficit in head injury. J Neurosurg. 1978;48:560–564
  18. Soustiel JF, Bruk B, Shik B, Hadani M, Feinsod M. Transcranial Doppler in vertebrobasilar vasospasm after subarachnoid hemorrhage. Neurosurgery. 1998;43:282–291
  19. Pezzini A, Del Zotto E, Padovani A. Hyperhomocysteinemia: a potential risk factor for cervical artery dissection following chiropractic manipulation of the cervical spine. J Neurol. 2002;249:1401–1403
  20. Nissen SE. Application of intravascular ultrasound to characterize coronary artery disease and assess the progression or regression of atherosclerosis. Am J Cardiol. 2002;89:24B–31B
  21. Nissen S. Coronary angiography and intravascular ultrasound. Am J Cardiol. 2001;87:15A–20A
  22. Dmowski AT, Carey MJ. Aortic dissection. Am J Emerg Med. 1999;17:372–375
  23. Honda Y, Grube E, de la Fuente LM, Yock PG, Stertzer SH, Fitzgerald PJ. Novel drug-delivery stent: intravascular ultrasound observations from the first human experience with the QP2-eluting polymer stent system. Circulation. 2001;104:380–383
  24. Regar E, Serruys PW. Ten years after introduction of intravascular ultrasound in the catheterization laboratory: tool or toy?. Z Kardiol. 2002;91(Suppl 3):89–97
  25. Thiel H. Gross morphology and pathoanatomy of the vertebral arteries. J Manipulative Physiol Ther. 1991;14:133–141
  26. Chopard R, Hubner De Miranda Neto M, Lucas G, Chopard M. The vertebral artery: its relationship with adjoining tissues in its course intra and inter transverse processes in man. Rev Paul Med. 1992;110:245–250
  27. Ekestrom S, Retamal E. Hemodynamic condition of the subclavian steal syndrome. Scand J Thorac Cardiovasc Surg. 1967;1:161–164
  28. Ahmad HA, Gerraty RP, Davis SM, Cameron PA. Cervicocerebral artery dissections. J Accid Emerg Med. 1999;16:422–424
  29. Mehalic T, Farhat SM. Vertebral artery injury from chiropractic manipulation of the neck. Surg Neurol. 1974;2:125–129
  30. Sherman DG, Hart RG, Easton JD. Abrupt change in head position and cerebral infarction. Stroke. 1981;12:2–6
  31. Sherman MR, Smialek JE, Zane WE. Pathogenesis of vertebral artery occlusion following cervical spine manipulation. Arch Pathol Lab Med. 1987;111:851–853
  32. Nakamura CT, Lau JM, Polk NO, Popper JS. Vertebral artery dissection caused by chiropractic manipulation. J Vasc Surg. 1991;14:122–124
  33. Siegel D, Neiders T. Vertebral artery dissection and pontine infarct after chiropractic manipulation. Am J Emerg Med. 2001;19:171–172
  34. Dagenais S, Haldeman S. Chiropractic. Prim Care. 2002;29:419–437
  35. Spitzer WO, Skovron ML, Salmi LR, Cassidy JD, Duranceau J, Suissa S, et al. Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining “whiplash” and its management. Spine. 1995;20:1S–73S
  36. Gurumoorthy D, Twomey L. The Quebec Task Force on Whiplash-Associated Disorders. Spine. 1996;21:897–898
  37. Astin JA, Ernst E. The effectiveness of spinal manipulation for the treatment of headache disorders: a systematic review of randomized clinical trials. Cephalalgia. 2002;22:617–623
  38. Terret AGJ. Current concepts in vertebrobasilar complications following spinal manipulation. In: Des Moines (IA): NCMIC; 2001;p. 42
  39. Lee KP, Carlini WG, McCormick GF, Albers GW. Neurologic complications following chiropractic manipulation: a survey of California neurologists. Neurology. 1995;45:1213–1215
  40. Haldeman S, Kohlbeck F, McGregor M. Risk factors and precipitating neck movements causing vertebrobasilar artery dissection after cervical trauma and spinal manipulation. Spine. 1999;24:785–794
  41. Murai T, Inui H, Miyahara H, Matsunaga T, Takano H. Hemodynamics of a simulation of the vertebrobasilar system using silicone tube. Acta Otolaryngol Suppl. 1998;533:30–35
  42. Chong BW, Kerber CW, Buxton RB, Frank LR, Hesselink JR. Blood flow dynamics in the vertebrobasilar system: correlation of a transparent elastic model and MR angiography. AJNR Am J Neuroradiol. 1994;15:733–745
  43. Li YK, Zhang YK, Lu CM, Zhong SZ. Changes and implications of blood flow velocity of the vertebral artery during rotation and extension of the head. J Manipulative Physiol Ther. 1999;22:91–95
  44. Sheth TN, Winslow JL, Mikulis DJ. Rotational changes in the morphology of the vertebral artery at a common site of artery dissection. Can Assoc Radiol J. 2001;52:236–241
  45. Fox MW, Piepgras DG, Bartleson JD. Anterolateral decompression of the atlantoaxial vertebral artery for symptomatic positional occlusion of the vertebral artery. Case report. J Neurosurg. 1995;83:737–740
  46. Sakai F, Ishii K, Igarashi H, Suzuki S, Kitai N, Kanda T, et al. Regional cerebral blood flow during an attack of vertebrobasilar insufficiency. Stroke. 1988;19:1426–1430
  47. Vicenzino B, Neal R, Collins D, Wright A. The displacement, velocity and frequency profile of the frontal plane motion produced by the cervical lateral glide treatment technique. Clin Biomech (Bristol, Avon). 1999;14:515–521
  48. Kawchuk GN, Herzog W. Biomechanical characterization (fingerprinting) of five novel methods of cervical spine manipulation. J Manipulative Physiol Ther. 1993;16:573–577
  49. Faris A, Poser C, Wilmore D, Agnew C. Radiologic visualization of neck vessels in healthy men. Neurology. 1963;13:386–396
  50. Symons BP, Leonard T, Herzog W. Internal forces sustained by the vertebral artery during spinal manipulative therapy. J Manipulative Physiol Ther. 2002;25:504–510
  51. Simon H, Niederkorn K, Horner S, Duft M, Schrockenfuchs M. Effect of head rotation on the vertebrobasilar system. A transcranial Doppler ultrasound contribution to the physiology. HNO. 1994;42:614–618
  52. Licht PB, Christensen HW, Hoilund-Carlsen PF. Vertebral artery volume flow in human beings. J Manipulative Physiol Ther. 1999;22:363–367
  53. Vaccaro A, Klein G, Flanders AE, Albert T, Balderston R, Cotler J. Long-term evaluation of vertebral artery injuries following cervical spine trauma using magnetic resonance angiography. Spine. 1998;23:789–794
  54. Haynes MJ, Cala LA, Melsom A, Mastaglia FL, Milne N, McGeachie JK. Vertebral arteries and cervical rotation: modeling and magnetic resonance angiography studies. J Manipulative Physiol Ther. 2002;25:370–383
  55. Alayon A, McKinney WM. Normal vertebral artery hemodynamics and pathology, vascular ultrasound of the neck. In:  Alayon A,  McKinney W editor. Vascular ultrasound of the neck: an interpretive atlas. Philadelphia: Lippincott Williams and Wilkins; 2001;p. 107–119
  56. Rivett DA, Sharples KJ, Milburn PD. Effect of premanipulative tests on vertebral artery and internal carotid artery blood flow: a pilot study. J Manipulative Physiol Ther. 1999;22:368–375
  57. Licht PB, Christensen HW, Hojgaard P, Marving J. Vertebral artery flow and spinal manipulation: a randomized, controlled and observer-blinded study. J Manipulative Physiol Ther. 1998;21:141–144
  58. Licht PB, Christensen HW, Hoilund-Carlsen PF. Is there a role for premanipulative testing before cervical manipulation?. J Manipulative Physiol Ther. 2000;23:175–179
  59. Cote P, Kreitz BG, Cassidy JD, Thiel H. The validity of the extension-rotation test as a clinical screening procedure before neck manipulation: a secondary analysis. J Manipulative Physiol Ther. 1996;19:159–164
  60. Rothwell D, Bondy S, Williams I. Chiropractic manipulation and stroke: a population-based case-control study. Stroke. 2001;32:1054–1060
  61. Haldeman S, Kohlbeck FJ, McGregor M. Unpredictability of cerebrovascular ischemia associated with cervical spine manipulation therapy: a review of sixty-four cases after cervical spine manipulation. Spine. 2002;27:49–55
  62. Mayer SA, Rubin BS, Starman BJ, Byers PH. Spontaneous multivessel cervical artery dissection in a patient with a substitution of alanine for glycine (G13A) in the alpha 1 (I) chain of type I collagen. Neurology. 1996;47:552–556
  63. Mettinger KL, Ericson K. Fibromuscular dysplasia and the brain: I. Observations on angiographic, clinical and genetic characteristics. Stroke. 1982;13:46–52
  64. Schievink WI, Michels VV, Piepgras DG. Neurovascular manifestations of heritable connective tissue disorders. A review. Stroke. 1994;25:889–903
  65. Lu CY, Hou JW, Wang PJ, Chiu HH, Wang TR. Homocystinuria presenting as fatal common carotid artery occlusion. Pediatr Neurol. 1996;15:159–162
  66. van den Berg JS, Limburg M, Kappelle LJ, Pals G, Arwert F, Westerveld A. The role of type III collagen in spontaneous cervical arterial dissections. Ann Neurol. 1998;43:494–498

 Sources of support: Financial support for materials used in this work was provided in part by the Canadian Chiropractic Protective Association. The authors receive salary support through the Canadian Institutes of Health Research and the Canadian Chiropractic Association (Dr Kawchuk), the Alberta Provincial CIHR Training Program in Bone and Joint Health (Dr Wynd), and by the Alberta Heritage Foundation for Medical Research (Dr Anderson).

PII: S0161-4754(04)00237-4

doi: 10.1016/j.jmpt.2004.10.005

Journal of Manipulative and Physiological Therapeutics
Volume 27, Issue 9 , Pages 539-546 , November 2004

Article Tools

* Image Usage & Resolution