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The study was completed using United Healthcare data of 35,726,224 commercial members and 3,188,825 Medicare Advantage members from 49 states. The analysis was conducted by researchers at Optum Health of Eden Prairie, Minnesota. From these data 1,159 vertebrobasilar artery (VBA) strokes were identified among the commercial member population and 670 among the Medicare Advantage population. For comparison each case of the 1829 cases which were identified as having a VBA stroke with occlusion or stenosis (ICD 433.0, 433.01, 433.20 or 433.21) was matched with four age and gender controls randomly selected from the sampled qualified members. Various analyses were conducted evaluating the time of contact with a chiropractor (DC) or a primary care physician (PCP), occurrence of VBA stroke relative to age (<45 years of age, > 45 years of age, relevant co-morbidities, total number of DC visits and PCP visits. Among commercial members: Age: 65.1 average, 64.7 median; Gender: 64.8 male, 35.2 female. Age among Medicare Advantage participants: 76.1 average, 76.2 median; Gender: 58.6 male, 41.4 female. “…our results showed there was no significant association between VBA stroke and chiropractic visits” “…our results did lend credence to previous reports that VBA stroke occurs more frequently in patients under the age of 45” “There was no significant association, when the data were sufficient to calculate estimates, between chiropractic visits and stroke regardless of the hazard period (timing of most recent visit to a chiropractor and the occurrence of stroke)” “Our results did add weight to the view that chiropractic care is an unlikely cause of VBA strokes. However, the current study does not exclude cervical manipulation as a possible cause or contributing factor in the occurrence of a VBA stroke.” The perspective that patients with neck pain and headache seek care from many providers and unfortunately some of these patients go on to have a cervical artery stroke is supported by this research as it was by the Cassidy study (2008). Neither this study nor the Cassidy study definitively state that a cervical manipulation can’t cause an arterial dissection but both do support the perspective that it is highly unlikely. The following details were present in the study:

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