As an important branch of chiropractic, spinal manipulation has made great progress in the past two decades, both in terms of basic theory and clinical methods. Spinal manipulation was created in the 1990s by Prof. Shen Guoquan, who combined the anatomy, imaging, and biomechanics of the spine of modern medicine with the holistic concept of traditional medicine and evidence-based treatment, with the traditional Chinese Tui Na orthopedic techniques, American orthopedic adjustments, and Japanese pelvic compression techniques. Based on anatomy, imaging and biomechanics, the spinal manipulation is based on the patient’s neurological symptoms and signs, careful palpation and physical examination, and the use of imaging data to correctly identify the patient’s spinal problems. We advocate the lightest force, the smallest passive movement of the spine, and the smallest joint manipulation to achieve the best clinical treatment results. The spine is adjusted by using the viscoelasticity of the spine to adjust the displacement of the vertebral body, correct the spatial alignment of the spinal segments and create a more relaxed internal environment for the nerves, blood vessels and spinal cord, thus eliminating or reducing the clinical symptoms and physical evidence and achieving the purpose of treating the disease. Spinal Fine-tuning Spinal manipulation is based on the theory of “adjustment” instead of “correction”, and does not necessarily require anatomical repositioning. When applying spinal manipulation, the efficacy is not judged on the basis of whether there is a popping sound or whether the spinous process is aligned, but rather on the basis of the improvement or disappearance of clinical symptoms and signs. Spinal fine-tuning techniques are guided by the holistic view of Chinese medicine, treating the upper disease and the lower disease, and are not only good at adjusting the local lesions that produce symptoms, but also focus on adjusting the biological force lines of the human spine. From the single-segment, local optimal spinal adjustment concept to a multi-segment, overall optimal spinal adjustment concept.