An article recently published in the January 1, 2007, issue of the journal Pediatrics (a journal of the American Academy of Pediatrics) addressed the issue of pediatric safety as it pertains to spinal manipulative therapy. The study by Vohra, et al., entitled, "Adverse Event Associated with Pediatric Spinal Manipulation," has incited questions and undue concern from the general public from news headlines that have misinterpreted this article. Our Research Director, Dr Joel Alcantara, has critically appraised the study by Vohra, et al., and the immediately retrievable supporting articles. His findings, thus far, are very revealing about the true nature of this publication, which he will address in a Letter to the Editor of Pediatrics and in articles to be published within our own profession. We will keep you updated.
As the largest pediatric chiropractic organization in the world, the International Chiropractic Pediatric Association is making these comments immediately to the profession (particularly to practicing chiropractors) to assure them that chiropractic care of children is safe. The ICPA is making these comments:
"In a review of the scientific literature spanning a period of 104 years, Vohra, et al., ultimately could only identify fourteen cases involving adverse events associated with spinal manipulation. Of these, ten were associated with chiropractic care. Of the ten cases, five patients experienced only minor adverse events (i.e., sore and stiff neck, sore back) that were self-limiting, did not require medical attention and were cared for successfully by the treating chiropractor. Incidentally, two of the five cases were incorrectly sub-typed by Vohra, et al. Of the articles documenting the five cases associated with severe adverse events (i.e., required medical care) as a result of chiropractic care, four were immediately retrievable. What does the data really show?
What becomes apparent after reading these articles is the following: The patients all had a pre-existing condition that was associated with the adverse event and/or had a history of significant trauma (i.e., gymnastic somersaults and falling on their heads and necks) prior to presenting to the chiropractor. To make cause and effect inferences (i.e., chiropractic care directly caused the adverse events) from these case reports is inappropriate. Furthermore, Vohra, et al.,’s cited cases involving delayed diagnosis and/or inappropriate provision of chiropractic care were based on testimonials and anecdotal evidence. Vohra, et al.,’s conclusion that "serious events may be associated with pediatric spinal manipulation" is unsubstantiated by the scientific literature and reflects a suspicious agenda against chiropractic by those who interpret it otherwise."
The ICPA recognizes the need and is committed to performing research on the safety and effectiveness of chiropractic care for children. Based on our Research Department review, we have prepared a statement for your concerned patients, a press release for your local papers and a news alert for your office newsletters. To stay tuned to all ICPA reports on this paper and future research projects that accurately assess the safety of chiropractic care for children, visit the ICPA website and sign up for our complimentary newsletter: http://www.icpa4kids.com/pedEx/.
Dr. Jeanne Ohm instructs internationally on the topic "Chiropractic Care for Pregnant Women and Children." She is Executive Coordinator of the International Chiropractic Pediatric Association: www.icpa4kids.com and can be reached at: