Debunking the Myth: Chiropractic Care and Cervical Artery Dissection

In this 'Deep Dive' episode of PCA Spinal Chat, the official podcast of the Pennsylvania Chiropractic Association, the hosts explore the controversial topic of neck pain, chiropractic care, and its alleged risk of causing cervical artery dissection (CAD). They examine a recent systematic review and meta-analysis that investigates the purported link between cervical manipulation and CAD. Despite finding a statistical association, the study's overall evidence quality is very low, primarily due to issues such as confounding factors, recall bias, and misclassification. The episode discusses critical findings from various studies, including the influential Cassidy study, which suggests that the apparent link is likely due to patients seeking care for pre-existing symptoms rather than the treatment causing the dissection. Ultimately, the hosts emphasize the importance of challenging widely held medical beliefs and the need for critical evaluation and evidence-based practice in healthcare.

00:00 Introduction to PCA Spinal Chat

00:05 Exploring Neck Pain and Chiropractic Care

00:14 Understanding Cervical Artery Dissection (CAD)

02:16 The Study: Separating Fact from Fear

02:35 Analyzing the Evidence

05:18 Confounding Factors and Misinterpretations

06:49 The Cassidy Study: A Crucial Insight

08:44 Weaknesses in the Reviewed Studies

10:39 Applying Hill's Criteria for Causation

13:19 Conclusion and Final Thoughts

14:54 Closing Remarks and Resources

Study Title: Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation

Authors: Ephraim W. Church, Emily P. Sieg, Omar Zalatimo, Namath S. Hussain, Michael Glantz, Robert E. Harbaugh

Journal: Cureus 8(2): e498 (2016)

DOI: https://doi.org/10.7759/cureus.498

PCA Website: https://pennchiro.org/

PCA Email: [email protected]