Lumbar disc herniation and cauda equine syndrome following spinal manipulative therapy.

Boucher P, Robidoux S. J Forensic Legal Med. Feb. 2014.

This interesting review of (6) Canadian court cases where Chiropractors were sued for allegedly causing a lumbar disc herniation after spinal manipulation. The highlights of the cases were:
1. Informed consent is an ongoing process and can’t be entirely delegated to office personnel.
2. When patient history reveals risk factors for lumbar herniation the DC has a duty to rule out disc pathology as an etiology for the symptoms before beginning anything but palliative treatments.
3. Lumbar disc herniation may be triggered by spinal manipulation on vertebral segments distant from the involved disc…such as the thoracic spine.