OBJECTIVETo discuss the characteristics of lumbar disc herniation (LDH) with symptom aggravated caused by spinal manipulative therapy (SMT).

METHODSDetailed clinical profiles of a total number of 10 LDH patients with symptoms aggravated after SMT were reviewed including 5 males and 5 females with age from 46 to 68 years old, 7 patients of them were more than 50 years old. The clinical data of 10 patients were analyzed involving age, gender, clinical symptoms, signs, imaging findings, surgical treatment and prognosis. Laminectomy and discectomy were performed, and follow-up was carried out in all patients.

RESULTSThe duration of symptoms in all the patients before SMT was 4 to 15 years. After the therapy, an acute exacerbation of back and radicular pain was observed within 24 hours. MRI showed intervertebral disc herniation, 7 patients were observed in L4-L5. The time internal between the exacerbation of presentation and surgery was 23.1 days. No perioperative complications occurred. All the patients were relieved of radicular pain a few days after surgery. During postoperative follow-up, all patients regained the ability to walk; Eight patients reported a complete resolution of presentation and the rest two patients were significantly improved.

CONCLUSIONSSMT should be prohibited in some LDH patients to prevent neurological damages, in whom there are 5 possible risk factors.