Biomechanical characteristics of cervical spine movement in cervical spondylotic myelopathy analyzed based on motion capture and Opensim simulation technology

• CSM patients exhibit significantly reduced peak motion angle changes in rotation and extension, but increased range of motion in lateral flexion, rotation, and extension compared to healthy controls. • The pressure center at C4 and C5 is more diffuse in CSM patients, indicating altered load distribution across the cervical spine. • Average muscle strength is markedly lower in CSM patients, while maximum joint pressure during extension is higher at C4-C6, suggesting a dynamic-static imbalance. • The study provides biomechanical evidence linking traditional Chinese medicine concepts of 'musculoskeletal imbalance' to modern 'dynamic and static imbalance' in CSM.