• Zhen Deng, Kuan Wang, Huihao Wang, Tianying Lan, Hongsheng Zhan, and Wenxin Niu.
• Baoshan Branch, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai, 201900, China.
• Eur Spine J. 2017 Sep 1; 26 (9): 2308-2317.

PurposeTraditional Chinese cervical manipulation (TCCM) has been claimed as an effective treatment for diseases of the cervical spine, but its biomechanical effects on the vertebral body and intervertebral discs remain unclear. The aim of this study was to develop and validate a detailed finite element model of cervical spine, which was then used to investigate the biomechanical response of the cervical spine to TCCM.MethodsThe model of a C2-T1 cervical spine was constructed based on CT images of a healthy male volunteer and validated against published in vitro studies under different loading conditions. The detailed force-time data of TCCM were measured on the same volunteer through dynamometric diaphragms. The data were applied on the validated finite element model to simulate TCCM.ResultsThe current model could offer potentials to effectively reflect the behavior of human cervical spine suitable for biomechanics studies of TCCM. Under simulated TCCM condition, the stress distributions in cervical spine and intervertebral discs could not be completely explained through the traditional theory.ConclusionSpinal manipulation, or TCCM, might play no role in reducing intradiscal pressure for treating cervical spondylosis. It could cause less stress concentration in intervertebral discs while operating spinal manipulation or TCCM when the adjustment points was chosen near the root of spinous process than the top of spinous process.

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