Conclusions:
Patients undergoing spinal manipulative therapy should be informed of the risk of stroke or vascular injury that could cause significant morbidity or even mortality from this procedure. Furthermore, we recommend increasing the awareness of the public about the potential complications from SMT and updating the International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) framework to incorporate Eagle’s syndrome in a comprehensive assessment, and palpation of the stylohyoid complex to help safe practice.