The safety of spinal manipulation in children

Researchers from the University of Alberta in Edmonton and the Canadian Memorial Chiropractic College in Toronto identified 13 articles from more than 14,000 in an initial literature search.

Here are the results.

  • There were 14 cases of direct adverse events (found in 10 English, 2 French, and 1 German language articles).
  • 10 occurred within a day of the procedure.
  • 9 cases were serious and resulted in hospitalization, permanent disability, or death.
  • All 9 serious adverse events occurred in children under 13 years of age.

The bottom line?
This is the first systematic review of adverse events related to pediatric spinal manipulation irrespective of language.

According to the authors?

  • “Spontaneous reports of adverse drug reactions suggest that less than 10% of serious adverse events are reported.”
  • “Concerns regarding both the quantity and quality of these spontaneous reports limit assessment of causation.”


  • “Given the large numbers of children who have received spinal manipulation during the decades assessed by our search strategy, adverse events resulting from spinal manipulation are either remarkably rare or underreported.”

5/28/07 10:53 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.