A key risk when performing HVLA in the cervical spine on a patient with underlying vascular disease is?

A key risk when performing HVLA in the cervical spine on a patient with underlying vascular disease is?

• A. Vertebral artery dissection or stroke risk.
• B. Lumbar strain.
• C. Ankle sprain.
• D. Pressure ulcer.

Answer: (A)

Cervical HVLA carries a real risk to the vertebral artery, especially in someone with vascular disease. The vertebral arteries travel up through the neck and can be stressed during rapid neck manipulation, particularly with rotation and extension. If the vessel is already diseased or fragile, an abrupt maneuver can cause an intimal tear—vertebral artery dissection—which may block blood flow or form clots, leading to a stroke in the posterior circulation. This is the main danger to watch for in this scenario. The other injuries listed aren’t the primary concern when performing cervical HVLA on someone with vascular disease, and safer approaches or avoidance of HVLA are advised in high-risk patients.

Cervical HVLA carries a real risk to the vertebral artery, especially in someone with vascular disease. The vertebral arteries travel up through the neck and can be stressed during rapid neck manipulation, particularly with rotation and extension. If the vessel is already diseased or fragile, an abrupt maneuver can cause an intimal tear—vertebral artery dissection—which may block blood flow or form clots, leading to a stroke in the posterior circulation. This is the main danger to watch for in this scenario. The other injuries listed aren’t the primary concern when performing cervical HVLA on someone with vascular disease, and safer approaches or avoidance of HVLA are advised in high-risk patients.