• Cervical rotation manipulation significantly increases stress on the intervertebral disc and facet joints compared to rotation-traction manipulation, potentially increasing the risk of disc injury.
• Rotation-traction manipulation more effectively expands the intervertebral foramen volume (19.8% increase) than rotation manipulation (15.5%), which may be beneficial for nerve root decompression.
• Cervical rotation manipulation promotes greater forward displacement of the herniated disc (1.067 mm vs. 0.960 mm), which may help in reducing nerve root compression.
• Both manipulations are effective for cervical radiculopathy, but the choice should be individualized based on the patient's specific pathology and biomechanical considerations.