Spinal manipulative therapy is an independent risk factor for XXXX .

@entity1 @entity64 @entity167 @entity4905 @entity4048 @entity158 @entity1317 @entity10 @entity4066 @entity385
OBJECTIVE: To determine whether spinal manipulative therapy (SMT) is an independent risk factor for cervical @entity4066 . METHODS: Using a nested case-control design, the authors reviewed all @entity1 under age 60 with cervical @entity4066 (n = 151) and @entity385 or @entity4905 from between 1995 and 2000 at two academic @entity64 centers. Controls (n = 306) were selected to match cases by sex and within age strata. Cases and controls were solicited by mail, and respondents were interviewed using a structured questionnaire. The medical records of interviewed @entity1 were reviewed by two blinded neurologists to confirm that the @entity1 had @entity64 or @entity4905 and to determine whether there was evidence of @entity4066 . RESULTS: After interview and blinded chart review, 51 @entity1 with dissection (mean age 41 +/- 10 years; 59% female) and 100 control @entity1 (44 +/- 9 years; 58% female) were studied. In univariate analysis, @entity1 with dissection were more likely to have had SMT within 30 days (14% vs 3%, p = 0.032), to have had neck or @entity10 preceding @entity64 or @entity4905 (76% vs 40%, p < 0.001), and to be current consumers of @entity167 (76% vs 57%, p = 0.021). In multivariate analysis, @entity4066 were independently associated with SMT within 30 days (OR 6.62, 95% CI 1.4 to 30) and @entity158 before @entity64 / @entity4905 (OR 3.76, 95% CI 1.3 to 11). CONCLUSIONS: This case-controlled study of the influence of SMT and cervical @entity4066 shows that SMT is independently associated with @entity4066 , even after controlling for @entity4048 . @entity1 undergoing SMT should be consented for risk of @entity64 or @entity1317 from the procedure. A significant @entity4048 following spinal manipulative therapy warrants immediate medical evaluation.
