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The pairwise comparisons between control and both the thoracic and cervical manipulation groups show a result in the limits of statistical significance only for the comparison between control and thoracic groups in CRP at zero hours posttreatment and for myoglobin at two hours posttreatment (Table 3).
This translates to less need for cervical manipulation and improved laryngeal view.
Stamm of the University of Colorado, Denver, described how cervical manipulation or membrane stripping preceded perinatal sepsis and even one instance of stillbirth caused by invasive group B streptococcus (GBS) as well as other pathogens.
On the basis of these case reports, obstetricians may want to reconsider doing elective cervical manipulation, at least on patients who have cervical vaginal infection or colonization with potential perinatal pathogens.
Referral for SMT should not be made to practitioners applying rotatory cervical manipulation. Information about the risk of VBA should be included in an informed consent procedure for cervical manipulation with thrust techniques.
Haldeman S, Carey P, Townsend M and Papadopoulos C (2001): Arterial dissections following cervical manipulation: the chiropractic experience.
(7) Some chiropractic spinal manipulation techniques, particularly those focusing on upper cervical manipulation, use thermographic and other diagnostic instruments to provide primary information to determine whether treatment should or should not occur.
Schneck, "Bilateral occipitalparietal hemorrhagic infarctions following chiropractic cervical manipulation," Seminars in Ophthalmology, vol.
Vertebrobasilar vascular accidents with cervical manipulation. In: Vernon H, ed.
Vectored upper cervical manipulation for chronic sleep bruxism, headache, and cervical spine pain in a child.
(57,64,88,89,96,97) However, two systematic reviews have concluded that there is limited to moderate evidence for the use of manual therapies, particularly cervical manipulation and mobilisation, in the management of this condition.
In a recent Master Class article (Hing et al, 2003) the New Zealand approach to teaching manipulation, in particular cervical manipulation was detailed.