than one spinal nerve root on one
side or of two adjacent roots in
one limb only.
4. Rheumatoid collagen necrosis of
vertebral ligaments; the cervical
spine is especially vulnerable.
5. Active inflammatory and infective
arthritis.
6. Bone disease of the spine.
Conditions that require special care in
treatment include the following: the
presence of neurological signs, 0steoporosis,
spondylolisthesis, and the
presence: of dizziness that is aggravated
by neck rotation or extension.9 Dmmented
cases in which spinal manipulation
has produced consequences
such as paraplegia, quadriplegia, and
brain-stem thrombosis illustrate the
potential danger of applying forceful
techniques and emphasize the need
for the clinician to proceed with skill,
judgment, and caution