Tuesday, August 19, 2014

What is the Risk of Vertebrobasilar Stroke and Chiropractic Care?

A study from the European Spine Journal found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care. The study was published in April 2009 edition and found the patients most likely came to the chiropractor or primary care physician with headache or neck pain because they were already had a VBA dissection.


Here is a summary of the study from NCBI:

Objective

To investigate associations between chiropractic visits and vertebrobasilar artery (VBA) stroke and to contrast this with primary care physician (PCP) visits and VBA stroke.

Methods

Cases included eligible incident VBA strokes admitted to Ontario hospitals from April 1, 1993 to March 31, 2002. Four controls were age and gender matched to each case. Case and control exposures to chiropractors and PCPs were determined from health billing records in the year before the stroke date. In the case-crossover analysis, cases acted as their own controls.

Results

There were 818 VBA strokes hospitalized in a population of more than 100 million person-years. In those aged less than 45 years, cases were about three times more likely to see a chiropractor or a PCP before their stroke than controls. Results were similar in the case control and case crossover analyses. There was no increased association between chiropractic visits and VBA stroke in those older than 45 years. Positive associations were found between PCP visits and VBA stroke in all age groups. Practitioner visits billed for headache and neck complaints were highly associated with subsequent VBA stroke.

Conclusion

VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care.