Abstract: 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; 96;106) 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.