Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
September 15, 2026Chiropractic & Manual TherapiesOpen Access

Association between spinal manipulative therapy and cervical artery dissection in patients with neck pain or headache: a retrospective cohort study

View Full Paper
Ask AI
Bookmark
Share

Authors

RTRobert J. TragerABAnthony N. BaumannCLCollin M. Labak

Discussion

Loading...

Member takes

Overview

Retrospective cohort study reveals reduced cervical artery dissection risk following spinal manipulation compared to ibuprofen in neck pain, indicating manipulation does not elevate tear risk.

Key Points

  • To evaluate the 30-day risk of cervical artery dissection following chiropractor-administered spinal manipulative therapy compared to ibuprofen prescription among adults presenting with new neck pain or headache.
  • Retrospective cohort study using United States TriNetX Linked health records and claims data from 2010 to 2025.
  • Propensity score matching was conducted to balance 431,492 patients receiving chiropractic cervical spinal manipulative therapy against 431,492 matched outpatients receiving an ibuprofen prescription.
  • Adults with prior cerebrovascular disease or cervical artery dissection were excluded, and outcomes were evaluated across 30 days of follow-up with less than 3% follow-up loss.
  • Patients receiving spinal manipulative therapy had a lower 30-day risk of cervical artery dissection compared to the ibuprofen cohort (RR = 0.53, 95% CI [0.35, 0.83]; risk difference = -6.3 [-10.8, -2.0] events per 100,000 patients; P = 0.004).
  • Risk of carotid artery dissection was significantly lower in the spinal manipulation group, whereas vertebral artery dissection risk did not differ significantly between cohorts.

Cite This Study

Trager et al. (2026) studied this question.

synapsesocial.com/papers/6aa9136e9013453be30a15fbhttps://doi.org/10.1186/s12998-026-00678-4
View Full Paper
Ask AI
Bookmark
Share