By Richard Pistolese, Research Assistant

International Chiropractic Pediatric Association

Recently I was asked, "What are the risks of chiropractic care for my child". I conducted an extensive Medline search covering the years 1966-1997, using the terms "chiropractic" and "children", so that I may find reports of adverse events which may have occurred in children as a result of chiropractic care. In more than 31 years of medical literature ! have only found one reported case of damage to a child as a result of chiropractic care and even this case is speculative at best.

According to this report a child with a rare spinal tumor presented to a chiropractor with reports of torticollis (Wry Neck). it is alleged by the author that tissue damage (necrosis) found in the area of the tumor, discovered during autopsy, was caused by 'chiropractic manipulation'. However, there exists no scientific proof that this damage was the result of a chiropractic adjustment. Speculation by this author is irresponsible. This particular tumor (an astrocytoma) has been commonly reported to be a congenital condition in numerous medical publications. Additionally the credentials of the person performing the manipulation are not discussed, while it may seem common sense that only chiropractors would be credited with making chiropractic adjustments, such is not the case.

Terrett has done an extensive review of literature, going back to 1934, and found that of 78 cases of vertebrobasilar stroke (none of which occurred in children) following 'chiropractic manipulation' 36% were not performed by chiropractors. You might then ask who is performing such manipulations, which are incorrectly being attributed to chiropractors? The answer is an Indian barber, a kung-fu practitioner, a blind masseur, medical doctors, nurses, osteopaths, physiotherapists, victim's wives', and persons doing self neck wrenching manipulation. I find that it is sad that such irresponsible reporting by so-called responsible medical researchers is printed and is misleading the public.

Estimates of risk &chiropractic adjustment are extremely low. I will use some figures to illustrate this point:

RISK IN PERSPECTIVE

Basis and Reference

Risk Reference

30% Incidence of adverse Drug Event in hospitalized patients Anderson 1992 10% Incidence of psychosis due to corticosteroid therapy Havey, 1984 7-10% Incidence of hepatitis due to blood transfusion. Stehling, 1986 6.1% Incidence of infection in postoperative orthopedic Patients Femandez, ET al., 1992 3.76% Incidence of nosocomial infection in hospitalized patients in the US CDC, 1991 1-2% Incidence of paralysis due to neurosurgery of the cervical spine Rocha vs. Harris, 1987 0.7% Incidence of esophageal perforation during anterior approach cervical spine surgery Van Berge Henegouwa ET al., 1991 0.3-0.9% Incidence of death due to cervical spine surgery (Graham, 1989 0.057% Incidence of seizure due to D.P.T. Vaccine CDC, 1994) 0.012% Incidence of breast cancer due to mammography (Bushong, 1984) 0.005-0.015% Incidence of death from radiation-induced malignancy due to x-ray exposure of 1-RAD (Bushong, 1984 0.025-0.01% Incidence of death due to radiocontrast media Atkinson & Kaliner, 1992 0.0008-0.001% Incidence of death due to allergic reaction to anesthetic agents Anderson, 1992 0.00002-0.00008% Incidence of death due to lightning in the U.S.A. (Eriksson & Ornehult, 1988) 0.00001-0.00003% Incidence of serious neural complications due to cervical manipulation Cyiax, 1978, and Gutman, 1983, respectively

As you can see, the risk of injury as a result of chiropractic adjustments is extremely low for adults and even smaller for the pediatric patient. With only one questionable report of injury to a child following chiropractic care 31 years of medical literature, potential risk is so low it can not even be estimated.

All references on file.

About the author: Richard Pistolese, B.Sc. has been a research assistant with the I.C.P.A. for over two years.

He is currently in his final year of study at Life University (6/98) and a former instructor of Chemistry at Life University. He has co-authored a research article with Dr. Bob Graham of Grandville , MI on a study performed by the Michigan Chiropractic Council. The article is titled, “An impairment rating analysis of asthmatic children under chiropractic care” and is published in the September issue of the Journal of Vertebral Subluxation Research. Volume 1, # 4 , Pages 29 - 36.

Reprinted with permission from I.C.P.A. newsletter September / October, 1997