Cervical Arterial Dissection Causes HVLA Manipulation Of Cervical Spine
An insidious onset cervical arterial dissection has caused a Clinician to provide a High-Velocity, Low-Amplitude (HVLA) manipulation to the cervical spine of a Patient. Tragically, soon after the manipulation, the Patient’s mild neck pain and headache rapidly progressed to those consistent with a cerebrovascular accident (CVA). The patient was transferred from the Clinic to the stroke unit of a nearby Hospital.
“It’s such a tragedy” explained Mark Bogglebrush, founder of the Bogglebrush Institute and a long time advocate for the safety of manipulative therapy to the cervical spine. “In these circumstances all we can do is try to do better next time. This could have happened to me, or you or any clinician around the world. These arterial dissections are sneaky buggers… they’re out there, and they’re just looking for a chance to camouflage themselves as a locked facet joint to trick clinicians into providing HVLA manipulations”.
The provider of the manipulation was to distraught to speak with our reporter, however, Mr Bogglebrush relayed that he had managed to speak with him and offer some advice.
“Yeah I had a quick word to him. I just wanted him to know that it’s not his fault. It wasn’t the manip that caused the dissection, the dissection caused the manip. I mean sure, maybe the manip helped kicked it off a bit, but that could have happened anytime. That guy’s artery was a ticking time bomb really. He should’ve known better than to go to Chiro or Physio in his condition. How is a clinician supposed to know that ahead of time? We don’t have x-ray vision! All we can do is crack the neck when we’re forced by the clinical presentation to do so. If they get better, job well done. If it turns out the reason they came for treatment was that they were already having a stroke, or some other shit, we just have to blame the fact that no one has worked out a way to screen for these things. I mean really, this was all just an unavoidable tragedy that we just have to move past”.
