A spinal manipulation device (30 80 90 100) adapted to protect, in use, a spinal cord from excessive axial and/or shear translations, the spinal manipulation device comprising a guide (31, 32 81, 82, 83 91, 92, 93 101, 102, 103) configured to constrain, in use, movement of a first arm (35 86 96106) relative to a second arm, the first arm and the second arm being fixable to and extending from a segment of spine undergoing manipulation, wherein, in use, the guide constrains movement of the first arm (35 86 96 106) relative to the second arm (36 87 97 107) to be about a substantially fixed centre of rotation located at least partially within the segment of spine undergoing manipulation, thereby protecting the spinal cord from excessive axial and/or shear translations.
