Joint, bone, spine : revue du rhumatisme
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Osteoporotic vertebral fractures selectively affect the thoracolumbar junction, usually sparing the cervical spine. A 65-year-old woman with documented osteoporotic fractures and chronic alcohol abuse presented with neck pain and occipital neuralgia that started after she suddenly flexed then extended her neck. Following several sessions of cervical manipulation, her pain became more severe, and she was admitted. ⋯ Osteoporosis was the only identifiable cause. The spinal manipulations probably worsened the lesions which were performed by a chiropractor who is not a physician and did not obtain cervical spine radiographs before treating the patient. Osteoporosis contraindicates spinal manipulation at any level, including the cervical spine.