2023, Vol. 27 ›› Issue (27): 4385-4392

Three-dimensional finite element method to analyze biomechanical characteristics of spinal manipulation

Liu Baijie, Zhou Honghai, He Xinyu, Qin Hongtu, Chen Longhao, Tian Junming, Lu Qingwang   

Abstract: BACKGROUND: As a physical therapy method with remarkable curative effect for spinal diseases, spinal manipulation has been widely used by scholars at home and abroad and gradually developed into standardization and systematization. Its mechanism of action and safety have always been the focus of medical attention. Three-dimensional finite element method is an effective tool for numerical simulation of human mechanical behavior. It has certain research value and clinical significance to clarify the biomechanical effect of manipulation on spinal structure through technical analysis.  
OBJECTIVE: To review the development of three-dimensional finite element method and its application in biomechanics of cervical, thoracolumbar and lumbar manipulations.
METHODS: The first author used “finite element, biomechanics, spine, cervical vertebrae, thoracolumbar, lumbar vertebra, manipulation” as English search terms, and used computer to search PubMed and Web of Science databases from establishment to April 2022. There were a total of 495 related articles. The “finite element analysis, spine, cervical spine, thoracic and lumbar spine, lumbar spine, massage, manipulation, biomechanics” were used as the Chinese search terms. A total of 593 related articles from the establishment of the database to April 2022 were checked in CNKI, Wanfang, and VIP databases using computers, and 80 of them were selected for review according to the inclusion criteria.  
RESULTS AND CONCLUSION: (1) Through the three-dimensional finite element method to analyze the stress and strain of the spine structure under the action of massage manipulation, the stress value and displacement value of each part of the model can be obtained, which can objectively, intuitively and accurately reflect the vertebral body, intervertebral disc, ligament, muscle, blood vessel, nerve, etc. The mechanical effect status of the components provides strong evidence for explaining the mechanism of spinal manipulation, improving the safety and effectiveness of manipulation, greatly promoting the development of clinical manipulation techniques, and has a good development potential. (2) The three-dimensional finite element method has made an important progress in the study of the biomechanics of spinal manipulation. The simulation of paravertebral soft tissue components of the spinal model has been continuously improved. The basic research of cervical and lumbar massage manipulations has continued to deepen, and the biomechanical analysis of massage manipulations has developed from solid mechanics to fluid mechanics. (3) However, there are still problems such as insufficient representation of the imaging sources of the spine model and the material setting data of each component in the current application. The simulation and loading of spinal manipulation manipulations are too simple, and many basic researches on thoracic manipulation manipulations have not been carried out. The researchers need to further improve, so that the three-dimensional finite element method can better meet the needs of clinical and scientific research of spinal manipulation.

Key words: three-dimensional simulation model, finite element analysis, spine, cervical spine, thoracolumbar spine, lumbar spine, massage, manipulation, biomechanics, review