Spinal Tuina is one of the unique therapies for the treatment of “subluxation”,while spinal Tuina palpation is in the whole process of spinal Tuina treatment.As one of the representative clinical diagnosis and treatment methods of Tuina,palpation is conducted by Tuina doctors to evaluate the “subluxation”,and to perform targeted repositioning maneuvers.However,the accuracy of spinal palpation is affected by spinal anatomical variation,one of the reasons for misdiagnosis and mistreatment in Tuina.However,there is limited literature about the interference caused by the spinal anatomical variation on spinal Tuina palpation.This paper discusses the influence of spinal anatomical variations including spinous process asymmetry bifurcation,length change,deviation,transverse process asymmetry,fusion,and transitional vertebra on spinal Tuina palpation,to provide references for Tuina palpation methods on spinal anatomical variations.