Index to Chiropractic Literature
Index to Chiropractic Literature
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Index to Chiropractic LiteratureIndex to Chiropractic LiteratureIndex to Chiropractic Literature
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Article ID
Title
URL https://chiromt.biomedcentral.com/articles/10.1186/s12998-018-0177-z
Journal Chiropr & Manual Ther. 2018 ;26(9):Online access only 11 p
Author(s)
Subject(s)
Peer Review Yes
Publication Type Article
Abstract/Notes

Over a period of decades chiropractors have utilized spinal manipulation under anesthesia (SMUA) to treat chronic back and neck pain. As an advanced form of manual therapy, SMUA is reserved for the patient whose condition has proven refractory to office-based manipulation and other modes of conservative care. Historically, the protocols and guidelines put forth by chiropractic MUA proponents have served as the clinical compass for directing MUA practice. With many authors and MUA advocates having focused primarily on anticipated benefit, the published literature contains no resource dedicated to treatment precautions and contraindications. Also absent from current relevant literature is acknowledgement or guidance on the preliminary evidence that may predict poor clinical outcomes with SMUA. This review considers risk and unfavorable outcomes indicators in therapeutic decision making for spinal manipulation under anesthesia. A new risk classification system is proposed that identifies patient safety and quality of care interests for a procedure that remains without higher-level research evidence. A scale which categorizes risk and outcome potential for SMUA is offered for the chiropractic clinician, which aims to elevate the standard of care and improve patient selection through the incorporation of specific indices from existing medical literature.

Author keywords: Manipulation under anesthesia — Spine — Medical evidence — Risk — Contraindications — Precautions — Outcomes — Informed consent

Author affiliations: DD: Consultant Practice- Whitestone, NY, USA; JLC: Clinical and Consultant Practice- Jersey City, NJ, USA; DSB: Clinical and Consultant Practice- Philadelphia, PA, USA

This abstract is reproduced with the permission of the publisher; click on the above link for free full text. PubMed Record

 
      

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