In order to explore and summarize the biomechanical characteristics of manipulation techniques using three-dimensional finite element analysis, reveal the mechanism of action of the techniques, and provide objective basis for the safety and optimization of the techniques. We searched for articles related to the biomechanical characteristics of lumbar manipulation techniques analyzed using three-dimensional finite element method in PubMed, Web of Science, CNKI database, Wanfang database, and VIPP database since the establishment of the database. The search term is "finite element analysis, biomechanics, lumbar spine, thoracolumbar spine, spine, manipulation, and massage". A total of 1238 articles were retrieved, and 41 articles that met the literature criteria were ultimately included. Resultly, the research on the biomechanical characteristics of lumbar spine manipulation techniques using three-dimensional finite element analysis mainly focuses on lumbar spine rotation techniques, oblique pull techniques, and extension and compression techniques. The research can objectively and accurately reflect the stress and displacement changes of various vertebral tissues during the manipulation process, providing standardized and standardized data support for guiding clinical practice, and improving clinical efficacy through manipulation optimization.

Zhang Lei, Yuan Haiguang, Gu Xinxin. Three-dimensional Finite Element Method Analysis of Biomechanical Characteristics of Lumbar Vertebra Manipulation. Academic Journal of Medicine & Health Sciences (2023) Vol. 4, Issue 11: 82-88. https://doi.org/10.25236/AJMHS.2023.041112.

[1] Liang Long, Zhu Liguo, Yu Jie, et al. Analysis on the quantification and biome echanics research of traditional Chinese medicine [J]. World Journal of Integrated Traditional and Western Medicine, 2020, 15 (06): 1165-1168. 

[2] Xu Haoxiang, Wen Wangqiang, Zhang Zipei, et al. Analysis on the quantification and biome echanics research of traditional Chinese medicine[J]. Chinese Journal of Tissue Engineering Research, 2020, 24 (15): 2425-2432. 

[3] Hu Hua, Xiong Changyuan, Han Guowu. Construction of a three-dimensional finite element model of "lumber-pelvic-hip" to simulate lumbar massage technique [J]. Journal of Clinical Rehabilitative Tissue Engineering Research, 2011, 15 (48): 8935-8938. 

[4] Gao Sen. Based on the finite element method to explore the influence of the lumbar fixed-point rotation reduction method on the lumbar spine stress after endoscopic spinal nucleus extraction [D]. Guangxi University of Traditional Chinese Medicine, 2021.

[5] Brekelmans W A, Poort H W, Slooff T J, et al. A new method to analyse the mechanical behaviour of skeletal parts [J]. Acta orthopaedica Scandinavica, 1972, 43(5):301-317. 

[6] Rybicki E F, Simonen F A, Weis E B, et al. On the mathematical analysis of stress in the human femur [J]. Journal of Biomechanics, 1972, 5(2):203-215. 

[7] Bi Sheng, Li Yikai, Zhao Weidong, et al. Comparative study of simulated lumbar manipulation techniques using biomechanical and three-dimensic nal finite element models [J]. Chinese Journal of Physical Medicine and Rehabilitation, 2002 (09): 16-19. 

[8] Wang Duoduo, Zhang Yanhai, Guo Panjing, et al. The Action Effect of Two Kinds of Lumbar Massage Obliquity Manipulation with Different Lumbar Degeneration Degrees:A Comparative Study [J]. Journal of Medical Biomechanics, 2023, 38 (01): 59-64+76. 

[9] Lu Yu, Xiang Junyi, Yin Benzheng, et al. Finite element comparative analysis on treatment of lumbar disc herniation by the oblique wrench method and the combination of traction, pressing, and oblique pulling [J]. Chinese Journal of Tissue Engineering Research, 2023, 27(13):2011-2015. 

[10] Zhou Nan, Lv Qiang, Fang Zhou, et al. Finite element analysis of Tuina manipulation on three-dimensional displacement of lumbar intervertebral disc protrusion [J]. Journal of Medical Biomechanics, 2013, 28 (03): 269-274. 

[11] Tian Cong. Finite Element Analysis on the Influences of Oblique-Pulling Method and the Rotary Reduction Manipulation on the Stress of Rear Lumbar Vertebra after Commonly-Used LDH Posterior Surgery [D]. Guangxi University of Chinese Medicine, 2017. 

[12] Tang Shujie. Two massage methods to treat lumbar disc herniation Comparison of biomechanical effects [C] // Chinese and Western Medicine Society Orthopedics Branch. Compilation. 2017: 727. 

[13] Shu Xinnong, Mu Wenzhi, Chen Jinfeng, et al. Comparison of biomechanical effect between oblique Ban-pulling manipulation and lumbar erection-rotati ion manipulation in sitting position for lumbar intervertebral disc herniation [J]. Journal of Acupuncture and Tuina Science, 2017, 15 (05): 317-321. 

[14] Zhang Renwen, Mo Zhuomao, Li Dong, et al. Biomechanical Comparison of Lumbar Fixed-Point Oblique Pulling Manipulation and Traditional Oblique Pulling Manipulation in Treating Lumbar Intervertebral Disk Protrusion [J]. Journal of Manipulative and Physiological Therapeutics, 2019, 43(5):446-456. 

[15] Xu Haitao, Li Song, Liu Lan, et al. Finite element analysis of the intervertebral disc during lumbar obligue-pulling manipulation [J]. Chinese Journal of Tissue Engineering Research. 2011, 15 (13): 2335-2338. 

[16] Zhang Hongwei, Zhang Xiaogang, Mao Lanfang, et al. The limited element analysis and guidance method to treat 29 cases of thoracic lumbar compressed fractures with osteoporosis [J]. Chinese Journal of Tissue Engineering Research, 2015, 28 (04): 51-53.

[17] Zhang Xiaogang, Dong Jianhua, Yang Xuefeng, et al. Biomechanical analysis of simulating pulling, extension and compression on the three-dimensional finite element model of lumbar segments [J]. Chinese Journal of Tissue Engineering Research, 2010, 14 (22): 4000-4004. 

[18] Li Jubao. Simulation and stret alhing method for the three -dimensional finite element of the lumbar spine movement section [D]. Gansu Institute of Traditional Chinese Medicine, 2008. 

[19] Yang Xuefeng. Simulation and pressing method of the three -dimensional finite element model of lumbar spine movement section of the lumbar spine movement section [D]. Gansu Institute of Traditional Chinese Medicine, 2008. 

[20] Zhang Xiaogang, Qin Daping, Song Min, et al. Effects of stress distribution of the degenerative intervertebral disc during lumbar pulling and pressing manipulation by Finite element analysis [J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2013, 28 (10): 3108-3114. 

[21] Shang Yong, Zhang Renwen, Mo Zhuomiao, et al. Finite Element Study on Lumbar Degeneration Influencing Biomechanical Action of Pulling and Pressing Manipulation [J]. Journal of Shandong University of Traditional Chinese Medicine, 2019, 43(02):151-154. 

[22] Chen Xinyi. At different angles, the limited element analysis of the stress on the lumbar spine at different angles of the elbow method [D]. Hunan University of Chinese Medicine, 2020. 

[23] Lu Qianyi, Chen Xinyi, Zheng Hui'e, et al. Stress and displacement of normal lumbar vertebra and posterior structure with different elbow pressing methods [J]. Chinese Journal of Tissue Engineering Research, 2022, 26 (09): 1346-1350. 

[24] Li Qingbing. The Aging Study of Caiqiao Manipulation Based on a Three -Dimensional Finite Model of Lumbar Segments [D]. Chengdu University of Traditional Chinese Medicine, 2016. 

[25] Zhou Ling. The Finite Element Analysis of the Effect of Spinal Manipulation Bed Simulating the Daogaijinbei Manipulation on Stress of Degenerative Lumbar Disc [D]. Fujian University of Traditional Chinese Medicine, 2018. 

[26] Li Yanting, Chen Jian, Liu Menglan, et al. Three-dimensional finite element analysis of Daogaijinbei manipulation on lumbar intervertebral disc biomechanics [J]. Chinese Journal of Tissue Engineering Research, 2022, 26 (03): 340-343. 

[27] Wang Guizhen. The Finite Element Analysis of the Effect of Spinal Manipulation Bed Simulating the Daogaijinbei Manipulation on Stress of Degenerative Lumbar Disc [D]. Fujian University of Traditional Chinese Medicine, 2020. 

[28] Ding Huaili, Liao Lijun, Yan Peichun, et al. Three-Dimensional Finite Element Analysis of L4-5 Degenerative Lumbar Disc Traction under Different Pushing Heights [J]. Journal of healthcare engineering, 2021, 2021:1322397-1322397. 

[29] Wang Lin, Huang Fasen, Sun Changhe, et al. Finite element analysis of bending and standing manipulation in the treatment of lumbosacral joint disorder [J]. China Journal of Orthopaedics and Traumatology, 2019, 32 (06): 519-523. 

[30] Lv Lijiang, Feng Zhe, Liao Shenghui, et al. FEM Analysis of Lever Positioning Technique Impact on Lumbar Disc [J]. Chinese Archives of Traditional Chinese Medicine, 2014, 32 (05): 971-973.

[31] Wu Shan, Zhang Meichao, Li Yikai, et al. The two types of sitting rotation techniques lumbar spine stress and displacement of finite element analysis [J]. Guangdong Medical Journal, 2010, 31 (08): 992-994. 

[32] Meng Qinghua, Bao Chunyu. Lumbar spine fixed-point rotation technique of limited element research [C] //. In 2009, Chinese sports medicine and arthroscopy surgery academic conference summary, 2009: 223-224. 

[33] Xu Haitao, Zhang Meichao, Xu Dachuan, et al. Analysis of effect on lumbar disc of rotat tion manipulation in three ante flexed levels by finit e element [J]. Chinese Journal of Convalescent Medicine, 2008 (02): 65-67. 

[34] Zhang Hui. Clinical observation on the therapeutic effect of nonspecific low back pain treated by lumbar sitting rotatory manipulation and preliminary study of Lumbar spinal finite element [D]. China Academy of Chinese Medical Sciences, 2015. 

[35] Chen Xin. Clinical and Finite Element Study of Seated Lumbar Rotation Manipulation in Treating Degenerative Lumbar Spondylolisthesis [D]. China Academy of Chinese Medical Sciences, 2014. 

[36] Wang Fei. Comparison of human lumbar disc and facet joint stresses and strains during two simulated spinal manipulative treatments [D]. China Academy of Chinese Medical Sciences, 2017.

[37] Li Li, Shen Tong, Li Yikai, et al. A Finite Element Analysis of Stress Distribution and Disk Displacement in Response to Lumbar Rotation Manipulation in the Sitting and Side-Lying Positions [J]. Journal of Manipulative and Physiological Therapeutics, 2017, 40(8):580-586. 

[38] Chen Jinfeng, Shu Xinnong, Tang Shijie, et al. Influence of lumbar disc degeneration on the efficacy of lumbar fixed-point rotation manipulation in sitting position: a finite element study [J]. Journal of Acupuncture and Tuina Science, 2016, 14 (04): 295-299. 

[39] Hu Hua, Xiong Chang-Yuan, Han Guo-Wu, et al. Finite element analysis of lumbar pelvic and proximal femur model with simulate lumbar rotatory manipulation [J]. China journal of orthopaedics and traumatology, 2012, 25(7):582-586. 

[40] Yu Jingjue. Research on the Establishment of Finite Element Model of Multiphase Materials for L4/5 Intervertebral Disc Common Protrusion and Rotational Manipulation Loading [D]. Guangxi University of Traditional Chinese Medicine, 2020. 

[41] Tian Qiang. Analyses of Stress and Displacement of Lumbar vertebrae during Simulating Sitting-Rotatory Manipulation by Finite Element [D]. Guangzhou University of Chinese Medicine, 2008.