There is a limited body of evidence to describe and quantify the risk of adverse events associated with spinal manipulation in children under 10 years of age. Although serious adverse events are reported in the literature, the risk of serious adverse events remains unknown. Most studies report mild and transient adverse events (e.g., increased crying, soreness, irritability). This review suggests that the risk of mild adverse events ranges from 0.3% in infants < 27 weeks old to 22.22% in children aged between 6 months and 6 years treated for inner ear infection. ~ Dr. Broussard
The safety of spinal manipulative therapy in children under 10 years: a rapid review
Melissa Corso, Carol Cancelliere, Silvano Mior, Anne Taylor-Vaisey & Pierre Côté
Chiropractic & Manual Therapies volume 28, Article number: 12 (2020)
Abstract
Introduction
The safety of spinal manipulative therapy (SMT) in children is controversial. We were mandated by the College of Chiropractors of British Columbia to review the evidence on this issue.
Objectives
We conducted a rapid review of the safety of SMT in children (< 10 years). We aimed to: 1) describe adverse events; 2) report the incidence of adverse events; and 3) determine whether SMT increases the risk of adverse events compared to other interventions.
Evidence review
We searched MEDLINE, CINAHL, and Index to Chiropractic Literature from January 1, 1990 to August 1, 2019. We used rapid review methodology recommended by the World Health Organization. Eligible studies (case reports/series, cohort studies and randomized controlled trials) were critically appraised. Studies of high and acceptable methodological quality were included. The lead author extracted data. Data extraction was independently validated by a second reviewer. We conducted a qualitative synthesis of the evidence.
Findings
Most adverse events are mild (e.g., increased crying, soreness). One case report describes a severe adverse event (rib fracture in a 21-day-old) and another an indirect harm in a 4-month-old. The incidence of mild adverse events ranges from 0.3% (95% CI: 0.06, 1.82) to 22.22% (95% CI: 6.32, 54.74). Whether SMT increases the risk of adverse events in children is unknown.
Conclusion
The risk of moderate and severe adverse events is unknown in children treated with SMT. It is unclear whether SMT increases the risk of adverse events in children < 10 years.