McGilvery W, Eastin M, Sen A, Witkos M (2019) Self Manipulated Cervical Spine Leads to Posterior Disc Herniation and Spinal Stenosis. Neurosurg Cases Rev 2:013.


© 2019 McGilvery W, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

CASE REPORT | OPEN ACCESS DOI: 10.23937/ncr-2017/1710013

Self Manipulated Cervical Spine Leads to Posterior Disc Herniation and Spinal Stenosis

Wyatt McGilvery, BS1*, Marc Eastin, MD2, Anish Sen, MD2 and Maciej Witkos, MS, MD1,3

1Department of Emergency Medicine, Loma Linda University, USA

2Department of Neurosurgery, Loma Linda University, USA

3Department of Emergency Medicine, University of California San Diego, USA


The authors report a case in which a 38-year-old male who presented himself to the emergency department with a chief complaint of cervical neck pain and paresthesia radiating from the right pectoral region down his distal right arm following self manipulation of the patient's own cervical vertebrae. Initial emergency department imaging via cervical X-ray and magnetic resonance imaging (MRI) without contrast revealed no cervical fractures; however, there was evidence of an acute cervical disc herniation (C3-C7) with severe herniation and spinal stenosis located at C5-C6. Immediate discectomy at C5-C6 and anterior arthrodesis was conducted in order to decompress the cervical spinal cord.

Acute traumatic cervical disc herniation is rare in comparison to disc herniation due to the chronic degradation of the posterior annulus fibrosus and nucleus pulposus. Traumatic cervical hernias usually arise due to a very large external force causing hyperflexion or hyperextension of the cervical vertebrae [1]. However, there have been reports of cervical injury arising from cervical spinal manipulation therapy (SMT) in which a licensed professional applies a rotary force component. This can be concerning, considering 12 million Americans receive SMT annually [2]. This case study involves an individual who was able to apply enough rotary force to his own cervical vertebrae, causing severe neurological damage requiring surgical intervention. Individuals with neck pain should be advised of the complications of SMT, and provided alternative treatment methods, especially if one is willing to self manipulate.