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Acute Thoracic Aortic Dissection After Chiropractic InterventionA Case Report
Michael R. Briseño, MD1; Gan Dunnington, MD2; Julius A. Bishop, MD1
1 Department of Orthopaedic Surgery, Stanford University Hospital, 450 Broadway Street Pavilion A, 2nd Floor MC 6120, Redwood City, CA 94063. E-mail address for M.R. Briseño: mrbriseno@gmail.com. E-mail address for J.A. Bishop: jabishop@stanford.edu
2 Department of Cardiothoracic Surgery, Stanford University Mountain View Hospital, 2490 Hospital Drive, Suite 104, Mountain View, CA 94040. E-mail address: dunning@stanford.edu
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Investigation performed at Stanford University Hospital, Redwood City, California

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Oct 23;3(4):e104 1-3. doi: 10.2106/JBJS.CC.M.00082
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Chiropractors make up the largest group of alternative medicine practitioners in the United States; 6% to 12% of the population utilize their services1,2. However, the scientific validity of the core chiropractic concepts of spinal manipulation and subluxation has been questioned, and concerns have been raised as to whether unnecessary manipulation can present a risk to patients3. There have been many case reports and small case series in the literature reporting the adverse effects of chiropractic care, with a particular focus on manipulation of the cervical spine4-9. However, there is a paucity of reports of adverse events following manipulation of the thoracic and lumbar spine. We present a case of a fatal thoracic aortic dissection following thoracic chiropractic manipulation. The patient’s family was informed that data concerning the case would be submitted for publication, and they provided consent.
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