A surgical fusion at L4-L5 would be considered a contraindication to adjust the cervical spine.

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Multiple Choice

A surgical fusion at L4-L5 would be considered a contraindication to adjust the cervical spine.

A history of a fusion in the lower spine does not automatically deny the possibility of adjusting the cervical spine. The safety of cervical manipulation hinges on cervical-specific factors—instability, a recent or active fracture, vertebral artery insufficiency, infection, inflammatory disease, or other red flags in the neck. If the cervical region is stable and without red flags, cervical adjustment can be appropriate even with an L4-L5 fusion elsewhere. Only cervical-related contraindications would push a clinician to avoid neck manipulation.

A history of a fusion in the lower spine does not automatically deny the possibility of adjusting the cervical spine. The safety of cervical manipulation hinges on cervical-specific factors—instability, a recent or active fracture, vertebral artery insufficiency, infection, inflammatory disease, or other red flags in the neck. If the cervical region is stable and without red flags, cervical adjustment can be appropriate even with an L4-L5 fusion elsewhere. Only cervical-related contraindications would push a clinician to avoid neck manipulation.

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