What is the role of pre-manipulative cervical vascular risk screening?

• A. To decide which exercises to prescribe
• B. To identify patients at risk of vascular complications during manipulation
• C. To determine patient insurance coverage
• D. To measure cervical spine ROM

Answer: (B)

The main purpose of pre-manipulative cervical vascular risk screening is to identify patients who may have vascular problems that could be worsened by cervical spine manipulation. The cervical area involves major arteries, so certain individuals—such as those with a history of stroke or transient ischemic symptoms, known vascular disease, connective tissue disorders, or recent neck trauma—could be at higher risk for vascular complications like vertebral artery injury during manipulation. By screening with targeted questions and looking for red flags (for example sudden neck pain with neurological signs, dizziness or vertigo, drop attacks, severe headaches, or other vascular symptoms), the clinician can decide whether it is safe to proceed, modify the technique, or refer for medical evaluation. The goal is patient safety during care. It isn’t about choosing exercises, measuring range of motion, or determining insurance coverage.