Acute Thoracic Aortic Dissection After Chiropractic Intervention: A Case Report.

Abstract

Chiropractors make up the largest group of alternative medicine practitioners in the United States; 6% to 12% of the population utilize their services1,2. However, the scientific validity of the core chiropractic concepts of spinal manipulation and subluxation has been questioned, and concerns have been raised as to whether unnecessary manipulation can present a risk to patients3. There have been many case reports and small case series in the literature reporting the adverse effects of chiropractic care, with a particular focus on manipulation of the cervical spine4-9. However, there is a paucity of reports of adverse events following manipulation of the thoracic and lumbar spine. We present a case of a fatal thoracic aortic dissection following thoracic chiropractic manipulation. The patient’s family was informed that data concerning the case would be submitted for publication, and they provided consent. A sixty-four-year-old woman with a history of midthoracic and lumbar back pain was in her usual state of health when she went to her regular chiropractor for a thoracic spine manipulation, which she had done on previous occasions. Immediately after treatment, she noted the acute onset of mid and low back pain associated with bilateral lower-extremity weakness and paresthesias. She was able to walk to her car from the chiropractic office, but the symptoms continued to worsen and she called emergency services from the vehicle. She was taken to an outside emergency room where she was noted to have profound bilateral symmetric lower-extremity weakness with subjectively diminished sensation. An emergency …