does do a lot of vertebral artery and carotid artery work. In a paper, he published in 2011, an editorial piece, he said, "It is not the intimal layer, which is what we've been taught all long, but rather the media and adventitia that are primarily affected in cervical artery dissection. These findings confirm the existence of an underlying systemic arteriopathy in patients with spontaneous cervical artery dissection and they suggest that the outer layers are primarily involved in the causation of the intramural hematoma." Now, let's again take this one apart, look at it again. "It's not the intimal but rather the media and adventitia," and so we were taught all long and I may have taught many of you that the attention we needed to pay was to the tunica intima and certainly it is important. What Schievink is saying is that in the cases of spontaneous cervical artery dissection, now other parties looking at patients who have this problem after our chiro want to say, "Well, that wasn't spontaneous, that was mechanical forces in these adjustments." What they are talking about here is that there is an underlying arteriopathy in patients with spontaneous cervical artery dissection. We know that patients with Marfan's disease, patients with Ehlers-Danlos syndrome, patients with autosomal dominant polycystic kidney disease, patients with Fibromuscular Hyperplasia, patients with extreme prolonged hypothyroidism, they all have a greater tendency than the average population to dissect. We then go on and also look at the genital variance, whether it's a lighting factor 5 or some other type of congenital variant in the collagen that causes that patient to be at risk for cervical artery dissection. This again is another important statement that again it isn't necessarily the forces that are involved, it's the underlying strength of the tissue involved, and it's a pathology in the tissue potentially in many of these cases; an important acknowledgment from a very leading person in this world. The next paper I would like to look at is from Walter Herzog, University of Alberta at Calgary, the guy has done wonderful work in the profession for years and years and years. Here in 2012, Herzog looked at vertebral artery strains during low amplitude cervical … High velocity low amplitude cervical spine manipulation or cervical spine adjustments. The conclusion that Herzog and his colleagues came to is that, "Vertebral artery strains obtained during spinal manipulative therapy are
Made with FlippingBook HTML5