• Oblique pulling manipulation increases annulus fibrosus stress and decreases nucleus pulposus stress with increasing disc degeneration, concentrating stress on the right lateral annulus and the junction of nucleus and annulus.
• The manipulation reduces overall disc displacement, left facet joint stress, and increases spinal cord stress, particularly in the upper cervical spine, as degeneration progresses.
• For mildly and moderately degenerated discs, the manipulation improves biomechanical balance by reducing nerve root stress and increasing the relative distance between the left nerve root and the disc.
• For severely degenerated discs, the manipulation may pose risks due to a sharp increase in annulus fibrosus stress and spinal cord compression, warranting cautious clinical use.