The effects of disc degeneration and muscle dysfunction on cervical spine stability from a biomechanical study

Disc degeneration and muscle dysfunction are common spinal degenerations in the elderly. This in vitro study was carried out to investigate the effects of these two degenerative changes on spinal stability. The stability of nine porcine cervical spines (C2-T1) with mechanically simulated cervical muscles (sternocleidomastoid (SCM), splenius capitis (SPL), semispinalis capitis (SSC)) was tested before and after experiment-induced disc degeneration. The patterns of muscle recruitments included: no muscle recruitment, normal recruitment of SCM/SPL/SSC, and SCM/SPL/SSC muscle dysfunctions. The neutral zone (NZ) and the range of motion (ROM) in the sagittal plane were measured to determine spinal stability. The results showed that the NZ and the ROM of a degenerative spine were larger than those of an intact spine under no muscle recruitment, but not under muscle recruitments. For both intact and degenerative spines, the NZ and the ROM were greatest under no muscle recruitment, followed by SSC dysfunction, SCM dysfunction, and SPL dysfunction, and smallest under normal muscle recruitment. In conclusion, muscle recruitments stabilize both intact and degenerative cervical spines, while dysfunctional muscles do not maintain stability efficiently as normal muscles do. Thus, spinal stability is more significantly affected by muscle dysfunction than by disc degeneration. Muscle training is suggested for the elderly with spinal degeneration to improve stability.