This case highlights the critical need for proper medical evaluation and imaging of severe back pain to rule out life-threatening conditions like aortic aneurysm before undergoing chiropractic manual therapy.
Raises caution for manual therapy with undiagnosed back pain; leaves open whether pre-treatment imaging prevents rare aortic events.
The reported case concerns the rupture of an aneurysm located in the descending part of the thoracic aorta during the procedure of the so-called "spinal adjustment" performed by a chiropractor. A 45-year-old patient with no significant medical history of cardiovascular diseases visited, along with his wife, one of "manual therapy" practices because of back pain. During the procedure, the patient suddenly lost consciousness. Despite cardiopulmonary resuscitation and emergency assistance given by an ambulance team, the patient died. An autopsy revealed that the cause of death was increasing cardiorespiratory failure secondary to bleeding into the lumen of the left pleural cavity following the rupture of pathologically altered thoracic aortic wall.
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Kaczorowska et al. (2014) studied this question.
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