טפול כירופרקטי בצוואר
ברק שלום מידי פעם, גורמים אינטרסנטיים כאלה או אחרים מעלים מחדש את נושא הסיכון בטיפול כזה. באופן כללי, מניפולציה גרמית של חוליות הצוואר היא אחת משיטות התרפיה הנפוצות והבטוחות ביותר בבעיות עמוד שדרה צווארי רבות ומגוונות. כל כירופרקטור יגש לנושא ההזהרות ואינדיקציות באופן המתאים לו ולמטופליו, אך איננו נוהגים להודיע לשום מטופל כי "יש לך סיכוי של 1 לשני מליון להפגע" ככלל קבוע. אני מעתיק את תמציתה של תשובת מנהל המחקר של מכללת הכירופרטיקה הקנדית CMCC, אותו שאלתי את השאלה הנוגעת לנושא המניפולציה בעמוד שדרה צווארי. קרא וחזור אלינו בשאלות אם משהו אינו ברור. > There have been two high profile cases in the last four years of death due > to stroke, apparently following manipulation. The one in Saskatoon (in > 1998) generated tremendous press there as a result of a Coroner's inquest. > The other one is not straight-forward and occurred in 1996 in Toronto. > Last Fall, the youngest child of this patient sued virtually the entire > organized profession for $12,000,000. The opponent I mentioned was at a > press conference announcing this suit. He had invited, as an "expert > witness" a neurologist, Dr. J. Norris who has been coordinating an ongoing > study of vertebral artery dissections and has collected about 70 cases. He > made his findings public in the news conference. He has never submitted > his work for peer-review or publication. We have been working closely with > him to find out what his methods were and to give him the benefit of our > extensive background in the area. We are very concerned about his methods, > particularly the way in which chiropractic treatment is attached as the > cause of the stroke. > > Anyway, what we've been able to determine is that he says that 60% of the > 70 strokes they have seen are spontaneous and the rest are "traumatic". Of > the traumatic ones, 40% are being labelled as "due to cervical > manipulation", which comes down to 11-12 cases. > > In our response to this hallaballoo, we have said that there appear to be > approx. 20,000,000 treatments in Canada per year in which at least one > cervical manipulation is rendered. If the incidence of vertebral artery > stroke from cervical manipulation is 1 in 1,000,000, then we'd expect to > see 20 cases per year. We certainly haven't heard about this many at any > time up to now. Norris' work is being quoted badly and used for its > propaganda value by our opponents. It turns out that there is some very > favorable research coming out of another group in Toronto, which I can't > reveal now, and which will be published soon. > > The situation is very similar to what happened in Denmark about 8 years > ago, when that country was rocked by one stroke death. That incident > prompted all of the work by LeBouef-Yde and Senstad which you may have seen > in the literature. Interestingly, some other new Danish work is > considerably downplaying the role of cervical manipulation in vertebral > artery compression. > > Anyway, I'm sure you can understand how two (alleged) stroke deaths could > roil up up our opponents, who have used the press masterfully to paint us > into a very tough corner, particularly with the University situation. > > Now, I'm not aware of what you described as a "medical alert" about the > matter. If you have any evidence about this, or can get any (i.e., ask > your colleague where and what he heard or saw), we would be very grateful > if you could get it for us. It could have been just a casual remark made > by one colleague to another that has been blown up like "broken telelphone" > to the point you heard it. But if someone is actually saying there's an > official alert or something like that, we's love to know about it. > > Take care my chaver! > > Howie >