The following is the summary of “Spinal manipulation and mobilization in the treatment of infants, children, and adolescents: a systematic scoping review” published in the December 2022 issue of Pediatrics by Milne, et al.

To identify and map the available evidence regarding the benefits and risks of spinal manipulation and mobilization for infants, children, and adolescents with various conditions; identify and synthesize the policies, regulations, position statements, and practice guidelines informing their clinical use.  A systematic scoping review was conducted using 4 electronic databases (PubMed, Embase, CINHAL, and the Cochrane Library) and grey literature from inception to February 4, 2021. Those that took part were newborns, kids, and teens (from 0-18 years old) who suffered from any kind of childhood ailment or condition. Mobilization and manipulation of the spinal column

The effects of typical childhood illnesses were investigated. Independently, 2 reviewers (A.P., L.L.) screened studies, selected studies, extracted key findings, and assessed the methodological quality of included papers using the Joanna Briggs Institute Checklist for Systematic Reviews and Research Synthesis, the Joanna Briggs Institute Critical Appraisal Checklist for Text and Opinion Papers, the Mixed Methods Appraisal Tool, and the International Centre for Allied Health Evidence Guideline Quality Checklist. Using levels of evidence strategy, a descriptive synthesis of the published findings was conducted. The collection totaled 87 articles. The quality of the articles’ methodologies varied widely. Clinically, chiropractors, physiotherapists, osteopaths, and other medical professionals are using spinal manipulation and mobilization to treat children and adolescents with a wide range of conditions, including adolescent idiopathic scoliosis (AIS), asthma, attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), back pain, breastfeeding difficulties, cerebral palsy (CP), dysfunctional voiding, excessive crying, headaches, infantile colic, kinetic imbalances According to the results of the descriptive synthesis, there is no concrete proof that spinal manipulation or mobilization is beneficial for any ailment in pediatric populations. Systematic evaluations of randomized controlled trials and other lower-quality research occasionally documented moderate to severe adverse effects in addition to the more common mild, temporary symptoms recorded in randomized controlled trials. 

For managing asthma (pulmonary function), headache, and nocturnal enuresis, there was strong to very strong evidence for ‘no substantial effect,’ but for all other disorders investigated, there was inconclusive or insufficient evidence. Spinal mobilization has not been well studied for use in treating any ailment affecting children. While there is promising evidence from a small number of high-quality studies, their descriptive synthesis of the combined findings does not lend credence to the use of spinal manipulation or mobilization in pediatric populations for any ailment. More adverse occurrences need to be reported so that real hazards can be assessed. There has to be more research done using randomized controlled trials to determine the efficacy of spinal manipulation and mobilization in children.