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Summary

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Results:  Twenty six fatalities were published in the medical literature and many more might have remained unpublished.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.