Effect of Lever Positioning Manipulation on Stress and Strain of Lumbar Spine and Intervertebral Disc
10.16466/j.issn1005-5509.2025.05.004
- VernacularTitle:杠杆定位手法对腰椎及椎间盘应力应变的影响
- Author:
Yu TIAN
1
;
Longhao CHEN
;
Xingchen ZHOU
Author Information
1. 浙江中医药大学附属第三医院 杭州 310005;浙江中医药大学第三临床医学院(康复医学院)
- Publication Type:Journal Article
- Keywords:
massage;
lever positioning manipulation;
lumbar intervertebral disc;
lumbar spine;
nucleus pulposus;
finite element;
stress;
strain
- From:
Journal of Zhejiang Chinese Medical University
2025;49(5):552-562
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]To analyze the effect of lever positioning manipulation(LPM)on the stress and strain of lumbar spine and intervertebral disc in different regions by using three-dimensional finite element technique,so as to reveal the biomechanical mechanism of manipulation.[Methods]A three-dimensional finite element model of the whole lumbar spine was constructed based on lumbar CT images,and the validity of the model was verified.The finite element model was used to analyze and compare the differences in the stress and strain of lumbar vertebrae and intervertebral discs by LPM at different manipulation points.[Results]The finite element model constructed indicates the point of manipulation is about 15 mm beside the L4 spinous process,the stress around the L4-5 intervertebral disc is large and the intermediate stress is small.The minimum strain point of the L4-5 intervertebral disc is about the lateral area of the intervertebral disc.The stress and strain of other intervertebral discs are similar to those of L4-5 intervertebral discs.The nucleus pulposus of L4-5 intervertebral disc move forward relatively to the lumbar spine;the stress under the lumbar pedicle is large,L4 has a certain degree of activity in the direction of extension,left bending and right rotation.Manipulation point is in the L4 spinous process,the stress around the L4-5 intervertebral disc is large and the intermediate stress is small.The minimum strain point of the L4-5 intervertebral disc is about the central area of the intervertebral disc.The stress and strain of other intervertebral discs are similar to those of L4-5 intervertebral discs.The nucleus pulposus of L4-5 intervertebral disc move forward relatively to the lumbar spine;the stress under the lumbar pedicle is large,and L4 has activity in the extension direction,and the activity in other directions is almost zero.[Conclusion]The LPM has the tendency to restore lumbar curvature and correct lumbar scoliosis and rotation.It can make the lumbar intervertebral disc move closer to the middle and make the nucleus pulposus move forward relatively to the posterior edge of the lumbar spine to reduce disc herniation and release compression.In the treatment of lumbar disc herniation,the manipulation points of the corresponding position can be selected according to the prominent position.
