Remote risk with neck manipulation 'nonsense'

Three local neurologists and 60 of their colleagues from across Canada have issued a letter highly critical of chiropractic neck manipulations on the fourth anniversary of the death of Saskatoon woman Laurie Jean Mathiason.

Their six concerns include banning neck manipulations on children and demanding government inquiries into the "dubious claims being made" about the procedure.

"There's deaths (from chiropractic neck manipulation) scattered throughout the literature. There's not a month that goes by that I don't see a patient," said neurologist Dr. Brad Stewart, one of the organizers of the letter.

Stewart, a professor at the University of Alberta, was a medical resident at the University of Saskatchewan at the time of Mathiason's death.

He said the claims made by chiropractors at that time and recently about a one-in-a-million risk of stroke from neck manipulation are "sheer nonsense."

A New England Journal of Medicine article pegged it at one in 20,000, he said.

He called the benefits of the procedure "few and far between," and said some studies show it does harm.

"The public must be made aware that the neurological damage that can result subsequent to upper neck manipulation can be debilitating and fatal," states the letter.

Saskatoon neurologist Dr. Christopher Voll, one of those who signed the letter, said there may be "limited and very short-term benefit" to the procedure, but it does not seem to outweigh the risk.

"I think a lot of the public may not be aware of the risks."

One of the other concerns is that the recommendations raised in an inquest into Mathiason's death have not been followed. Mathiason died in February 1998 after her artery was punctured during a chiropractic neck manipulation.

Her mother, Sharon Mathiason, said it has been a "very difficult day" for her, remembering her daughter and the way she died.

"My daughter is dead. Now I try to protect others," she said. "The neurologists and myself are fed up. If consumers knew what the real risk of injury was, they would not want this done. It's dangerous. It's unwarranted. It's barbaric."

Dr. Robert Kitchen, registrar for the Chiropractors Association of Saskatchewan (CAS), said he hasn't seen the letter, but said many of the inquest recommendations have in fact been heeded.

For example, he said chiropractors have pamphlets in their offices explaining the risk of neck manipulation.

There are also consent forms signed by each patient who undergoes the procedure.

The other two Saskatoon neurologists to sign the letter are Dr. Jeff Donat and Dr. Carol Boyle.