Deaths after Chiropractic: A Review of Published Cases

E. Ernst


Int J Clin Pract. 2010;64(10):1162-1165. 

In This Article

Abstract and Introduction


Objective: The aim of this study was to summarise all cases in which chiropractic spinal manipulation was followed by death.
Design: This study is a systematic review of case reports.
Methods: Literature searches in four electronic databases with no restrictions of time or language.
Main outcome measure: Death.
Results: Twenty six fatalities were published in the medical literature and many more might have remained unpublished. The alleged pathology usually was a vascular accident involving the dissection of a vertebral artery.
Conclusion: Numerous deaths have occurred after chiropractic manipulations. The risks of this treatment by far outweigh its benefit.


Vascular accidents after upper spinal manipulation are a well-recognised problem (e.g.[1,2]). Dissection of a vertebral artery, caused by extension and rotation of the neck beyond the physiological range of motion, is thought to be the underlying mechanism.[2] Several deaths have been reported as a consequence. Some proponents of chiropractic seem to believe that the critical evaluation of this evidence amounts to a 'scare story' (Chairman of the UK General Chiropractic Council)[3] or to 'puffing up (the evidence) out of all proportion' (President of the British Chiropractic Association).[4] A responsible approach to serious therapeutic risks, however, requires an open discussion of the facts.

In this review, I aimed to provide the basis for such a discussion by summarising all fatalities which occurred after chiropractic spinal manipulation and were published in the medical literature.


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