Methods of Literature Review.To the Editor: "Manipulation of the Cervical Spine cervical spine Clinical anatomy The region of the vertebral column encompassing C1 through C7 : Risks and Benefits" by Di Fabio[1] (January 1999) addressed a very important and controversial topic. We would like comment on the method of literature review. One purpose of the article was "to review previously reported cases in which injuries were attributed to [manipulation of the cervical spine]."[1(p50)] On the basis of the literature review, "several recommendations for future studies and for the practice of manipulation of the cervical spine are discussed."[1(p50)] The author reviewed 116 articles that globally described 177 cases and cited 210 references. It is surprising that, for such a huge effort, the author did not use the commonly used MEDLINE The online medical database of the U.S. National Library of Medicine (NLM) whose parent is the National Institutes of Health, Bethesda, MD. MEDLINE contains millions of articles from thousands of medical journals and publications. The consumer section of the site (http://medlineplus. .[2] It must be noted that the term "manipulation" was not included in the researched key words, and this is the main topic of the article (in fact, the term is included in the title and in the key words of the article). This may be the reason of the lack of some papers on this issue. We reported on 4 patients with cervical myelopathy myelopathy /my·elop·a·thy/ (mi?e-lop´ah-the) 1. any functional disturbance and/or pathological change in the spinal cord; often used to denote nonspecific lesions, as opposed to myelitis. 2. caused or aggravated by cervical spinal manipulation.[3,4] It is important to note that, in one of these cases, cervical magnetic resonance imaging magnetic resonance imaging (MRI), noninvasive diagnostic technique that uses nuclear magnetic resonance to produce cross-sectional images of organs and other internal body structures. was available before and after manipulation. Along with others in the evidence-based medicine evidence-based medicine Decision-making 'The use of scientific data to confirm that proposed diagnostic or therapeutic procedures are appropriate in light of their high probability of producing the best and most favorable outcome'. See Meta-analysis. community,[2] we believe that literature reviews must be performed exhaustively, using sensitive tools that now are easily available. This is essential, particularly when the purpose is to provide guidelines or recommendations for professional practice. In these cases, a complete and impartial review must be performed, as it usually is in secondary publications. References [1] Di Fabio RP. Manipulation of the cervical spine: risks and benefits. Phys Ther. 1999;79:50-65. [2] Sackett D, Richardson WS, Rosenberg W, Haynes RB. Evidence-Based Medicine: How to Practice and Teach EBM EBM Evidence-Based Medicine EBM Electronic Body Music EBM ecosystem-based management EBM Evidence Based Medical (statistics) EBM Environmentally Benign Manufacturing EBM Expressed Breast Milk EBM Executive Board Meeting . London, England: Churchill Livingstone; 1997. [3] Padua L, Padua R, LoMonaco M, Tonali E Radiculomedullary complications of cervical spinal manipulation, spinal Cord. 1996;34: 488-492. [4] Padua L, Padua R, Tonali P. Risk of manipulative cervical treatment. Spire. 1997;22: 1676-1677. Luca Padua, MD, PhD Roberto Padua, MD Irene Aprile, MD Pietro Tonali, MD Institute of Neurology and Orthopaedics Universita Cattolica Fondazione Pro Iuventute Don C Gnocchi gnoc·chi pl.n. Dumplings made of flour, semolina, or potatoes, boiled or baked and served with grated cheese or a sauce. [Italian, pl. Rome, Italy |
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