Adverse Events Associated With Pediatric Spinal Manipulation: A Systematic Review

@article{Vohra2007AdverseEA,
  title={Adverse Events Associated With Pediatric Spinal Manipulation: A Systematic Review},
  author={Sunita Vohra and Bradley C Johnston and Kristie Cramer and Kim B. Humphreys},
  journal={Pediatrics},
  year={2007},
  volume={119},
  pages={e275 - e283}
}
BACKGROUND. Spinal manipulation is a noninvasive manual procedure applied to specific body tissues with therapeutic intent. Although spinal manipulation is commonly used in children, there is limited understanding of the pediatric risk estimates. OBJECTIVE. Our goal was to systematically identify and synthesize available data on adverse events associated with pediatric spinal manipulation. METHODS. A comprehensive search was performed of 8 major electronic databases (eg, Medline, AMED, MANTIS… 
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Most of the articles identified in this literature review did not use terminology consistent with the standards established by the ICH when reporting on safety incidents following pediatric spinal manipulation or chiropractic manipulative therapy.
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Performing a thorough history and examination to exclude anatomical or neurologic anomalies before applying any manual therapy may further reduce adverse events across all manual therapy professions.
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None of the systematic reviews generated conclusive evidence to suggest that spinal manipulation is an effective treatment for any paediatric condition, and the safety of spinal manipulation in paediatrics is less than clear.
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A search of the literature between 2007 and 2011 investigating the use of spinal manipulative therapy for pediatric health conditions found studies that monitored both subjective and objective outcome measures of relevance to both patients and parents tended to report the most favorable response to SMT, especially among children with asthma.
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TLDR
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