Cervical Spine Manipulations: Role of Diagnostic Procedures, Effectiveness, and Safety from a Rehabilitation and Forensic Medicine Perspective: A Systematic Review
Andrea Bernetti,
Raffaele La Russa,
Alessandro de Sire,
Francesco Agostini,
Stefania De Simone,
Giacomo Farì,
Giorgia Viola Lacasella,
Gabriele Santilli,
Stefania De Trane,
Michele Karaboue,
Pierangela Ruiu,
Massimiliano Mangone,
Massimiliano Leigheb,
Valter Santilli,
Pietro Fiore
Affiliations
Andrea Bernetti
Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
Raffaele La Russa
Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
Alessandro de Sire
Italian Society of Physical and Rehabilitation Medicine (SIMFER), 00198 Rome, Italy
Francesco Agostini
Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
Stefania De Simone
Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
Giacomo Farì
Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari “Aldo Moro”, 70124 Bari, Italy
Giorgia Viola Lacasella
Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
Gabriele Santilli
Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University, 00185 Rome, Italy
Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
Pierangela Ruiu
Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
Massimiliano Mangone
Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
Massimiliano Leigheb
Orthopaedics and Traumatology Unit, “Maggiore della Carità” Hospital, Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy
Valter Santilli
Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
Pietro Fiore
Italian Society of Physical and Rehabilitation Medicine (SIMFER), 00198 Rome, Italy
Background: Cervical spine manipulations (CSM) have been performed for centuries and are a widely practiced intervention to manage cervical spine musculoskeletal disorders. We aimed to perform an overview of the literature concerning the effects and the adverse events of CSM in the Physical and Rehabilitation Medicine (PRM) field with a forensic medicine perspective. Methods: A search in the scientific literature (PubMed, Google Scholar, PEDro and Cochrane) was carried out from inception until October 2020. Results: Fourteen articles were included in this narrative summary. The possible development of side effects requires a careful mandatory balance of benefits and risks even when there is an indication for this approach. Moreover, a qualified professional is essential to perform CSM–a non-invasive therapeutic procedure that can be potentially harmful. Conclusions: In conclusion, it is essential to perform the diagnosis, to treat, and to manage complications within the PRM field, both for the reduction of malpractice claims and, most importantly, for the safety of the patient.
