OBJECTIVETo investigate the three-dimensional anatomical position of the rotatory center in cervical rotatory and local manipulation.

METHODSA three-dimensional model was constructed based on CT data from cadaveric specimens of axial spinous process deviation. Cervical rotation was simulated on this model, and the graphic outcome was analyzed.

RESULTSThe rotatory center of this model was at the dens axis, not at the apex of the axial spionus process, and the angle of rotation exceeded observable angle.

CONCLUSIONThe new concept of anisotropic rotation of the cervical vertebrae should be established and its principles must be comprehended in clinical practice of cervical rotatory manipulation.