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Manual therapy is one of the effective methods in treating neck pain. It has certain advantages in the short term to ease the symptoms of neck pain. In recent years, using different mechanical sensors and imaging equipment with computer software, the researchers found the difference of cervical activity between health adult and patients with neck pain. They also analyzed the kinematics, magnitude of force, stress and strain of the related structure and other mechanical parameters during cervical manipulation. These biomechanical researches revealed the functional anomaly caused by neck pain, reflect the safety of cervical manipulation, explain the abnormal stress of neck pain and the adjusting role of manipulation. Relatively speaking, these studies are too basic, and their analysis also are limited for the stress and strain about internal tissue. Study to aim directly at above problems will have important significance in understanding neck pain and standardizing manipulation therapy.

To review previously reported injuries cases which were associated with cervical manipulation in China, and to describe the risks and benefits of the therapy.Relevant case reports, review articles, surveys, and investigations regarding treatment of cervical spondylosis with cervical manipulation involving accidents and associated complication were retrived with a search of the literature from SinoMed, CNKI, CQVIP, and Wanfang digital databases between 1979 to March 2011. The data were extracted and statistically analyzed.Total of 150 cases of injury reported in 40 articles corresponded the inclusion criteria. Accidents occurred in 156 cases,of them,syncope was in 45 cases (28.85%), mild spinal cord injury or compression was in 34 cases (21.79%), nerve root injury was in 24 cases (15.38%), ineffective or symptom increased was in 11 cases (7.05%); cervical spine fracture was in 11 cases (7.05%), dislocation or semiluxation was in 6 cases (3.85%), soft tissue injury was in 3 cases (1.92%), serious accident was 22 cases (14.70%, including paralysis, death and cerebrovascular accident). In cases of serious accident, 12 cases (54.55%) had the other primary diseases. Types of related manipulation including rotation reduction (42.00%, 63 cases), rubbing points or muscle resulting strong stimulation (28.00%, 42 cases). 100 cases (66.67%) obtained cured or basically recovered results, 21 cases (14.00%) improved, 4 cases (2.67%) deterioration and 5 cases (3.33%) died.It is imperative for practitioners to complete the patients' management and assessment before manipulation. That the practitioners conduct a detailed physical examination and make a correct diagnosis would be a pivot method of avoiding accidents. Excluding contraindications and potential risks, standardizing evaluation criteria and practitioners' qualification, increasing safety awareness and risk assessment and strengthening the monitoring of the accidents could decrease the incidence of accidents.

To evaluate the safety and efficacy of the manipulation treatment for vertebral artery type of cervical spondylosis and analyze the current status of clinical study.To retrievie the PubMed, OVID, Cochrane library, CBM-disc database, CNKI database, VIP database, 265 literatures of the manipulation treatment of vertebral artery type of cervical spondylosis were collected, including 251 literatures Chinese and 14 literatures English. Among the literatures, 5 studies of Chinese literatures accorded with inclusion criteria. Cochrane systematic review was used to quality evaluation; and 5 studies were used RevMan 4.2 for Meta analysis of literature.Five documents included a total of 736 patients. Summary of the literature combined OR for the cure rate was 2.93, 95% CI was [2.10,4.08]. Summary OR for the combined efficiency was 3.99, 95% CI was [2.47,6.44]. Manipulation group's cure rate of vertebral artery type of cervical spondylosis was efficient and clearly superior to the other therapies. Expect of the manipulation, the traction and the drugs, hereinafter referred to as "other therapies" (P0.01).At present, documents included in this study have shown that manipulation treatment on vertebral artery type of cervical spondylosis is safe, both cure rate and the effective rate are much better than other therapies; but the incorporation of a limited number of documents and the quality is not very high, the conclusion is still uncertain, high-quality evidence should be needed to be further validated.

Traditional Chinese spinal manipulative therapy (TCSMT) and Chiropractic are similar in treating related with spinal disease, but they keep different characteristics of themselves. Although Chiropractic's "Subluxation" and TCSMT's "Jin Chu Cao and Gu Cuo Feng" theory have not be widely recognized, yet Chiropractic has already have official cooperation with WHO,and has launched "WHO Basis of Chiropractic Training and Security Guide" which would promote the project further research. Comparatively, TCSMT has mature theoretical system and satisfactory clinical effectiveness, but it's hard to global spreading formally and legally. By means of cogitation of the TCSMT'S basic theories and clinical applications, this paper aims to analyze the inadequacy aspects of it, and hope to borrow some Chiropractic's advantage to TCSMT's global spreading. And I wish this paper could be helpful for relative doctors and researchers.