경추 추나치료의 안전성에 대한 임상보고 = The Safety of Cervical Chuna Manipulation; Mechanism, Adverse Reactions and Cases Report

다국어 초록 (Multilingual Abstract)

Objectives : The aim of the present study was to report the safety of cervical Chuna manipulation treatment (CCMT). We investigated the mechanism and complications of adverse reactions associated with CCMT, and newly demonstrated three cases in litigation. Methods : We searched relevant case reports, surveys, and review articles using a comprehensive databases of online and bibliography, combed adverse cases in clinical field. Results : A relative-to-absolute contraindication to cervical Chuna manipulation was circulatory and haematological disorders, neurological disorders, bone-weakening and destructive disorders, articular derangement or psychological factors. The majority of adverse reactions were mild or moderate in 85~90%, began within 4 h and generally disappeared within the next 24 h, at least one of them was reported by 30.0~60.9% of the patients after cervical manipulation. The most common were local discomfort (15.2~53.0%), headache (10.0~19.8%), stiffness (19.5~25.0%), tiredness (10.0~12.1%), or radiating discomfort (10.0~23.0%). The two of reported clinical cases were the occurrence of retropharngeal hematoma and cervical herniated disc disease after CCMT. The one was not a fault of practitioner, but complain for compensation. Conclusions : Manipulation of the cervical spine may also be associated with higher complication rates than previously reported. Although It is difficult to estimate the incidence of cervical manipulation complications, it is important to differentiate those patients who are susceptible to adverse reactions in order to inform them correctly.

참고문헌 (Reference)

1 "한방재활의학" 군자출판사 245 (245): 2005

2 "추나요법이 경항부 통증질환에 미치는 임상적 효과" 1 (1): 67-82, 2000

3 윤유석, "추나요법 후 악화된 요추 추간판 탈출증 1례" 5 (5): 163-168, 2004

4 김학선, "추나 요법 후 악화된 요추 추간판 탈출증" 33 (33): 1326-1333, 1998

5 "정형 추나의학" 척추신경추나의학회 57 -59, 2006

6 "경추추나치료 후 발생한 경막파열 환자 1례 보고" 1 (1): 45-50, 2006

7 "경추 추나치료 후 발생한 뇌졸중 1례" 21 (21): 264-270, 2000

8 "경추 추나요법이 추골동맥과 기저동맥 혈류에 미치는 영향" 1 (1): 45-53, 2000

9 "경부척추조작술 또는 경부수상과 관련된 척추기저동맥계뇌경색 3례" 15 (15): 858-866, 1997

10 "WHO Library Cataloguing-in-Publication Data. WHO guidelines on basic training and safety in chiropractic" World Health Organization 19-27, 2005

11 Hufnagel A, "Stroke following chiropractic manipulation of the cervical spine" 246 : 683-638, 1999

12 Smith WS, "Spinal manipulative therapy is an independent risk factor for vertebral artery dissection" 60 (60): 1424-1428, 2003

13 Ernst E, "Spinal manipulation: Its safety is uncertain" 166 (166): 40-41, 2002

14 "Side-effects of chiropractic spinal manipulation: types frequency, discomfort and course" 14 (14): 50-53, 1996

15 Leboeuf-Yde C, "Side effects of chiropractic treatment: a prospective study" 20 (20): 511-515, 1997

16 "Safety in chiropractic practice. Part II: Treatment to the upper neck and the rate of cerebrovascular incidents" 19 (19): 563-569, 1996

17 "Safety in chiropractic practice, Part I: The occurrence of cerebrovascular accidents after manipulation to the neck in Denmark from 1978-1988" 19 (19): 371-317, 1996

18 Oppenheim JS, "Nonvascular complications following spinal manipulation" 5 (5): 660-666, 2005

19 "Neurologic complications following chiropractic manipulation" 45 (45): 1213-1215, 1995

20 Ernst E., "Manipulation of the cervical spine: a systematic review of case reports of serious adverse events, 1995-2001" 176 (176): 376-380, 2002

21 Cagnie B, "How common are side effects of spinal manipulation and can these side effects be predicted?" 9 (9): 151-156, 2004

22 "Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study" 30 (30): 1477-1484, 2005

23 Senstad O, "Frequency and characteristics of side effects of spinal manipulative therapy" 22 (22): 435-440, 1997

24 "Effect of vertebral manipulation therapy on vertebro- basilar artery blood flow in cervical spondylosis of vertebral artery type" 25 (25): 742-744, 2005

25 Assendelft WJ, "Complications of spinal manipulation: a comprehensive review of the literature" 42 (42): 475-480, 1996

26 "Complications of cervical spine manipulation therapy: 5-year retrospective study in a single-group practice" 13 (13): 2002

27 Haldeman S, "Clinical perceptions of the risk of vertebral artery dissection after cervical manipulation: the effect of referral bias" 2 (2): 334-342, 2002

28 "Chiropractic technique(한국어판)" 대한추나학회출판사 128-137, 2000

29 Mann T, "Causes of complications from cervical spine manipulation" 48 (48): 151-, 2002

30 "Adverse reactions to chiropractic treatment and their effects on satisfaction and clinical outcomes among patients enrolled in the UCLA Neck Pain Study" 27 (27): 16-25, 2004

31 Barrett AJ, "Adverse effects of spinal manipulation" 93 (93): 258-259, 2000

32 "A prospective study of complications of cervical spine manipulation" 4 : 166-170, 1996