Letter to the Editor: Chiropractor and dissections

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To The Editor: I read with interest the recent article by Albuquerque and coauthors (Albuquerque FC, Hu YC, Dashti SR, et al: Craniocervical arterial dissections as sequelae of chiropractic manipulation: patterns of injury and management. Clinical article. J Neurosurg 115:1197–1205, December 2011). Their article contains very strong language implicating manipulation as a cause of stroke. However, this paper is essentially an observational case series reporting the clinical vignettes of 13 patients who the authors claim developed craniocervical arterial dissections as the sequelae of chiropractic manipulation. It is a fundamental principle of epidemiology

Article Information

Please include this information when citing this paper: published online March 30, 2012; DOI: 10.3171/2011.10.JNS111811b.

© AANS, except where prohibited by US copyright law.

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References

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Cassidy JDBoyle ECôté PHe YHogg-Johnson SSilver FL: Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Spine (Phila Pa 1976) 33:4 SupplS176S832008

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Dupeyron AVautravers PLecocq JIsner-Horobeti ME: [Complications following vertebral manipulation—a survey of a French region physicians.]. Ann Readapt Med Phys 46:33402003. (Fr)

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Murphy DR: Current understanding of the relationship between cervical manipulation and stroke: what does it mean for the chiropractic profession?. Chiropr Osteopat 18:222010

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Cassidy JDBoyle ECôté PHe YHogg-Johnson SSilver FL: Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Spine (Phila Pa 1976) 33:4 SupplS176S1832008

3

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