Objective To investigate the radiological findings of protruded nucleus pulposus(PNP) and vertebral subluxation at the involved segment in the aged patients with lumbar disc herniation(LDH),and explore their clinical significances. Methods Thirty aged LDH patients who were consecutively admitted in our hospital from December 2014 to December 2015 were recruited in this study and assigned as the observation group. They were all successfully and conservatively treated by Feng’s Spinal Manipulation (FSM). Another 30 age- and gender-matched patients diagnosed with asymptomatic LDH (ALDH) during their annual physical exam. were subjected as control group. The “T” value (the space occupation of lumbar PNP in vertebral canal), “AV” angle (the nerve root canal stenosis of PNP), vertebral rotation (VR) angle, vertebral tilt (VT) angle, Oswestry disability index (ODI) of lower limb, nerve root sign (NRS),and paraspinal sign (PS)at the involved segment were compared before and after the treatment, and between the 2 groups. A correlation analysis was also conducted between the radiological findings at involved segment and the clinical manifestations of the patients. Results Compared with the control group, the VR and VT angles were significantly higher in the observation group before the treatment (P<0.05), and that of VR was obviously increased after treatment (P<0.05). The VR and VT angles, NRS, PS and ODI were remarkably decreased in the observation group after the treatment than before (P<0.05). NRS, PS and ODI were positively correlated with the values of VR and VT angles (rNRS/VR=0.600, rNRS/VT=0.431, rPS/VR=0.386, rPS/VT=0.408, rODI/VR=0.814, rODI/VT=0.567, all P<0.05). Conclusion (1) Our study proves that the elderly LDH patients can live well with PNP, and conservative treatment doesn’t obtain its efficacy by changing the morphology of the herniated nucleus pulposus. (2) The signs of mechanical imbalance at the involved vertebrae are important indictors to evaluate the clinical severity of the manifestations. (3) Correcting of “vertebral subluxation” might be one of critical principles in treatment of the elderly LDH patients.