Occurrence and changes of adverse events in manipulative treatment of cervical spondylosis during 2012-2023 and the prevention countermeasures
Objective:To analyze the occurrence and changes of adverse events in manipulative treatment of cervical spondylosis(CS)during 2012-2023,and to explore the corresponding prevention countermeasures.Methods:All the articles about adverse events in mani-pulative treatment of CS included from January 1,2012 to December 31,2023 were retrieved from the Chinese Biomedical Literature Service System,China National Knowledge Infrastructure,Wanfang Database,and Vip Database through computer,followed by statistics and analysis on the types,grades,and outcomes of adverse events as well as the types of manipulations causing adverse events,and the results were com-pared with the findings of the articles published during 1979-2011.Results:①Article retrieval and screening results.Nine hundred and ninety-seven articles were searched out.After screening,42 articles were included in the final analysis,involving 219 patients and 224 ad-verse events(3 adverse events were recorded if one patient experienced dizziness,upper limb numbness,as well as nausea and vomiting simul-taneously).②Analysis result of occurrence of adverse events in manipulative treatment of CS during 2012-2023.Among the 224 adverse events in manipulative treatment of CS during 2012-2023,the top three ones were dizziness(22.32％),local pain(20.54％),nausea and vomiting(15.63％)in turn,and the mild,moderate,and severe adverse events were 217,3,and 4,respectively.Among the 219 patients,the adverse events were caused by rotation reduction in 83 cases,acupoint massage in 77 cases,and pulling-stretching manipulation in 12 cases,with 47 cases not specifying the manipulations that led to the adverse events,and the outcomes of adverse events were reported in 35 cases,all of which were recovery or basic recovery,while the outcomes were not reported in 184 cases.③Changes of adverse events in manipulative treatment of CS during 2012-2023.Compared with the period of 1979-2011,the period of 2012-2023 witnessed increased types of adverse events,but decreased number of moderate and severe adverse events in manipulative treatment of CS,with dizziness ac-counting for the highest proportion in the adverse event.Rotation reduction manipulation led to the most adverse events,followed by acupoint massage,and the adverse events caused by pulling-stretching manipulation increased significantly.In addition,the adverse events were dom-inant by the mild ones,the proportion of the moderate and severe ones decreased significantly.Besides,the number of cases without repor-ting the outcomes of adverse events substantially increased,and no death case was identified in the screening process.Conclusion:During 2012-2023,the adverse events in manipulative treatment of CS were still mostly caused by rotation reduction manipulation and acupoint massage,predominantly by mild ones,which can be recoverable.Compared with the period of 1979-2011,the period of 2012-2023 wit-nessed decreased number of moderate and severe adverse events but increased types of adverse events,with a significant increase in adverse events caused by pulling-stretching manipulation.Efforts should be made to improve case data,standardize the operation of manipulations,decipher the functioning mechanisms of manipulations,strictly regulate the qualifications of practitioners,enhance the risk awareness of medical staff,and strengthen the active communication between doctors and patients,which can effectively prevent and reduce the occur-rence of adverse events in manipulative treatment of CS.
万方数据
