Three-dimensional finite element analysis of the oblique-pulling manipulation on lumbar disc herniation in different body positions

doi:10.12307/2021.357

Abstract

Abstract: BACKGROUND: Oblique-pulling manipulation showed great effectiveness in treating patients with lumbar disc herniation, and had been extensively used in clinic; however, the biomechanics and efficacy of the oblique-pulling manipulation in different positions are still undefined.
OBJECTIVE: To analyze the biomechanical effect of the oblique-pulling manipulation in different body positions of lumbar disc herniation using three-dimensional finite element, so as to guide its treatment and associated clinical work.
METHODS: A three-dimensional finite element model of L4-5 was developed from the CT scan images of a volunteer. The oblique-pulling manipulation was simulated to study the influence in different positions (anteflexion 30°, neutral position 0° and extension 10°) on the stress on the intervertebral disc, including the nucleus pulposus and annulus fibrosus, and the changes in the displacement between the intervertebral disc and the nerve root under the oblique-pulling manipulation.
RESULTS AND CONCLUSION: (1) Under the oblique-pulling manipulation in different body positions: anteflexion 30°, neutral position 0°, and extension 10°, the stress in the intervertebral disc nucleus pulposus was significantly reduced; the most obvious reduction occurred when the extension was 10°. (2) Under the oblique-pulling manipulation in different body positions: anteflexion 30°, neutral position 0°, and extension 10°, the stress on the annulus was increased; the most obvious increase occurred when the extension was 10°. (3) When anteflexion was 30°, the disc was far away from the nerve root under oblique-pulling manipulation, which helps to relieve the symptoms of nerve compression. However, in the extension of 10°, the opposite is true.

Key words: lumbar, segmental motion, three-dimensional finite element, oblique-pulling manipulation, biomechanics

CLC Number:

Lu Yu, Zheng Taicai, Wang Qi, Zhang Jing, Cheng Qiang, Ji Futao, Yin Benjing, Bao Chaoyu, Jia Tao, Li Jizheng, Li Jubao. Three-dimensional finite element analysis of the oblique-pulling manipulation on lumbar disc herniation in different body positions[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(36): 5872-5877.

Figures/Tables 7

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