Cervical artery dissection: a biomechanical perspective

Complete and total apologist for the chiropractic profession. I will never get my neck adjusted. These guys will say anything to not take responsibility.
I won't have this done for these reasons;
1. Call for age limit after chiropractor breaks baby's neck
2. 'My chiropractor gave me locked-in syndrome, but I survived': Astonishing recovery of woman, 46, who beat the odds to walk and talk  again
3. Woman claims stroke stems from spinal manipulation by chiropractor
4. Comparing chiropractic neck adjustment to hanging
5.  Mitchell, SD chiropractor denies causing Gunkel's stroke
6.  Cerebrospinal fluid leak secondary to chiropractic manipulation
7.  Chiropractor forged consent form after patient's stroke
8.  Letting a chiropractor 'crack' your neck to ease pain could trigger stroke
9.  Deaths after chiropractic: a review of published cases.
10.  Chiropractic stroke

The  apologist here:
Cervical artery dissection: a biomechanical perspective

276

J Can Chiropr

Assoc 2013; 57(4)

Commentary

Introduction

Although there has been a putative ??? link between cervical

spinal manipulative treatment (cSMT) and cervical artery

dissection (CAD) ever since Thornton’s report in the literature in 1934¹

, recent evidence suggests that this is an association rather than a causal relationship. Since 2008, several studies published by Cassidy and co-workers^2-4

have attributed the association between cSMT and CAD

to patients seeking chiropractic care for neck pain and

headaches during the prodrome ??? of a stroke.

Most reviews in the literature now generally report

that there are no convincing data, either to prove or disprove, any causality between cSMT and CAD⁵. (really?)

However, case reports and case series still accumulate that identify

chiropractic as the sole cause of CAD^6-7.

Furthermore, Tuchin⁸ recently tested the causality between CAD and SMT using Hill’s criteria, and concluded that there is no evidence that SMT is causally related to stroke. Nevertheless, some authors continue to claim that cSMT causes CAD.

Rather than using an epidemiologic approach to assess

the risk of whether cSMT can cause CAD, another approach is to investigate the mechanism(s) of how cSMT can cause CAD. Since 2002⁹, our laboratory has focused on the latter strategy. Using cadaveric vertebral arteries (VAs) as a model for the in vivo neck, we have measured

the strains experienced by VAs using ultrasonography to dynamically measure the changes in VA segment lengths during manipulative procedures. The details of the experimental procedures have been described elsewhere^9-11.

We have now replicated these experiments on a total of 16 VAs obtained from 10 cadavers^9-11 in 3 different papers. 

You can read the rest of the blathering at the link.