Mechanism of Cervical Vertebra Oblique Manipulation Analyzed Based on Three-Dimensional Finite Element Technique

JIANG Xuejia; ZHAO Hongfei; ZHANG Wenxia; WANG Yishan; YAN Chunchun; WANG Congan

doi:10.16295/j.cnki.0257-358x.2024.11.014

Abstract：Objective:To study the biomechanical effects of cervical oblique manipulation on cervical radiculopathy and the immediate effects and safety of cervical oblique manipulation through finite element analysis.Method:Cervical image data of a volunteer with radiculotic cervical spondylosis were collected and stored in DICOM format.MIMICS software and ANYSY software were applied to construct the finite element model of C3～C7 cervical vertebra such as vertebra,intervertebral disc and spinal canal,and the oblique manipulation was simulated to observe the changes in the stress and strain of intervertebral disc and the effective cross-sectional area of spinal canal.To investigate the biomechanical effect of oblique manipulation in the treatment of cervical radiculopathy.Results:The stress of the C4～C5 intervertebral disc was the highest when the C4～C5 vertebral body was subjected to the left oblique pull force,ranging from 5.95 × 10-4 MPa to 1.03 × 102 MPa.The maximum strain was 2.43 × 10-1 mm on the left side of the annulus,and the minimum strain was 2.08 × 10-3 mm on the anterior side of the annulus.The effective cross-sectional area of the spinal canal varies the most between C4～C5,increased by 59.00 mm2.With the loading of the mechanical information of the simulation manipulation,the maximum strain on the right side of the cervical nerve root gradually shifted backward,and the minimum strain on the left side shifted forward,in a clockwise direction.Conclusions:The driving force of cervical oblique manipulation to the healthy side has the greatest effect on the intervertebral disc.Oblique manipu-lation can increase the effective cross-sectional area of the spinal canal,reduce the tension of the tissue around the nerve root,relieve the compression,and thus improve the clinical symptoms of cervical spondylotic radiculopathy.