Philadelphia Managing Partner John Salvucci recently wrote an article for Dynamic Chiropractic proposing further research that will help determine whether strokes occurring following high-velocity, low-amplitude chiropractic cervical manipulation (CM) are the result of the evolution of a dissection that was present prior to CM, or the result of a dissection caused by CM.
Titled "Stroke Timing and Vertebral Artery Dissection: What the Window Suggests" the article begins by noting that CM is associated with VAD because of the numerous reports of patients experiencing a stroke shortly after CM. Mr. Salvucci notes that scientific studies to date have concluded that there is no evidence of causation, yet the debate continues. Mr. Salvucci offers a novel hypothesis which, if tested, will add additional evidence on this issue.
Hypothesis: It is accepted that if a VAD occurs and results in a thromboembolic stroke, it will occur within thirty days, and the strokes will cluster around the seven-to-fourteen-day period. However, there is an ongoing debate about whether CM can cause a VAD. If CM can cause a VAD then these events would be distributed throughout the course of chiropractic care. However, if the VAD preceded the CM then the strokes would occur within thirty days of the inception of chiropractic care.
The article concludes by encouraging researchers to conduct retrospective studies to test this hypothesis
Mr. Salvucci is the Managing Partner of Lewis Brisbois' Philadelphia office and the National Co-Chair of the Life Sciences Practice. He regularly associates in the defense of high-exposure cases. In this capacity, he is often engaged as a consultant to understand the key medical and scientific issues, identify and retain preeminent authorities, and formulate the defense strategy. In addition, Mr. Salvucci serves as national counsel in mass tort cases and has directly defended hundreds of claims for a wide range of clients.
Read the full Dynamic Chiropractice article here.