ArticleScientific reports2023
A retrospective analysis of the incidence of severe adverse events among recipients of chiropractic spinal manipulative therapy.
Article in Scientific reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
47 citing papers in PubMed, 5 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Adverse events following cervical spine self-manipulation: A systematic review.PM & R : the journal of injury, function, and rehabilitation · 2026Pooled it
- Chiropractic Management of Adults with Cervicogenic or Tension-Type Headaches: Development of a Clinical Practice Guideline.Journal of integrative and complementary medicine · 2026Pooled it
- Adverse events among older adults receiving chiropractic spinal manipulation and related treatments: an updated systematic review.Chiropractic & manual therapies · 2026Pooled it
- Efficacy and safety of spinal manipulative therapy in the management of acute neck pain: a systematic review and meta-analysis.Systematic reviews · 2025Pooled it
- Clinical Practice Guideline for Best Practice Management of Pediatric Patients by Chiropractors: Results of a Delphi Consensus Process.Journal of integrative and complementary medicine · 2024Guideline
- Chiropractic patient compensation claims in Norway from 2013 to 2024.Chiropractic & manual therapies · 2026Article
- Chiropractic spinal manipulative therapy versus physical therapist-led exercise and the risk of cauda equina syndrome in adults with lumbar disc herniation, stenosis, or radiculopathy.PM & R : the journal of injury, function, and rehabilitation · 2026Article
- Efficacy of spinal manipulative therapy in older adults with chronic spinal conditions: an updated systematic review.The Journal of the Canadian Chiropractic Association · 2026Article
- Contextual factors related to aging determine force-based manipulation dosage: a prospective cross-sectional study.Chiropractic & manual therapies · 2025Article
- Chiropractic Palliative Care for a Veteran With Chronic Low Back Pain and Advancing Testicular Cancer: A Case Report.Journal of chiropractic medicine · 2025Article
- Integrated manual therapies: IASP taskforce viewpoint.Pain reports · 2024Article
- An Additive Effect of Instrument-Assisted Soft Tissue Mobilization with Spinal Manipulation in Cervicogenic Headache: a Randomized Controlled Trial.Pain and therapy · 2024Article
- Article
- Multimodal management for low-back pain associated with spondylodiscitis.Medicine and pharmacy reports · 2024Article
- Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations.Journal of clinical medicine · 2024Review
- Internal carotid artery pseudoaneurysm after neck manipulation in a patient with Eagle syndrome.Clinical case reports · 2024Article
- Plausible Mechanisms of Causation of Immediate Stroke by Cervical Spine Manipulation: A Narrative Review.Cureus · 2024Review
- Notalgia Paresthetica Responding Positively to Chiropractic Spinal Manipulation: A Case Report.Cureus · 2024Article
- Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study.BMC musculoskeletal disorders · 2024Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This study examined the incidence and severity of adverse events (AEs) of patients receiving chiropractic spinal manipulative therapy (SMT), with the hypothesis that < 1 per 100,000 SMT sessions results in a grade ≥ 3 (severe) AE. A secondary objective was to examine independent predictors of grade ≥ 3 AEs. We identified patients with SMT-related AEs from January 2017 through August 2022 across 30 chiropractic clinics in Hong Kong. AE data were extracted from a complaint log, including solicited patient surveys, complaints, and clinician reports, and corroborated by medical records. AEs were independently graded 1-5 based on severity (1-mild, 2-moderate, 3-severe, 4-life-threatening, 5-death). Among 960,140 SMT sessions for 54,846 patients, 39 AEs were identified, two were grade 3, both of which were rib fractures occurring in women age > 60 with osteoporosis, while none were grade ≥ 4, yielding an incidence of grade ≥ 3 AEs of 0.21 per 100,000 SMT sessions (95% CI 0.00, 0.56 per 100,000). There were no AEs related to stroke or cauda equina syndrome. The sample size was insufficient to identify predictors of grade ≥ 3 AEs using multiple logistic regression. In this study, severe SMT-related AEs were reassuringly very rare.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.