Biomechanical influence of the therapeutic position on the efficacy of chinese manipulation in treating lumbar disc herniation

Purpose: To determine the favorable therapeutic position for Chinese manipulation in treating lumbar disc herniation. Methods: We developed a three-dimensional finite element model of L3-5 for the normal spine, along with a mild degeneration and a moderate degeneration model, and carried out a comparative study between the manipulation with lateral position and that with sitting position. The displacement and stress distribution in the intervertebral disc of L4 were investigated. Results: A displacement and stress directing forwards concentrated on the left rear of L4 disc were found in the three models under the two manipulations. The values of displacement and stress under the manipulations with lateral position are larger than those with sitting position in the three models. Conclusion: Lateral position has a better biomechanical effect than sitting position in treating lumbar disc herniation.