Exploring the characteristics of neck muscle strength and activation in patients with cervical spondylotic radiculopathy using motion capture-Opensim digital simulation technology

• Patients with cervical spondylotic radiculopathy exhibit significant muscle synergy imbalance in all cervical movements, with affected side muscles under-activated and healthy side muscles over-compensating. • The sternocleidomastoid and middle/upper trapezius show the most pronounced degeneration, serving as key biomechanical features of the disease. • Motion capture combined with OpenSim digital simulation provides a novel method to quantitatively assess dynamic neck muscle strength and activation, overcoming limitations of static imaging. • The study offers biomechanical evidence supporting the 'muscle-bone imbalance' theory in cervical spondylotic radiculopathy, potentially guiding rehabilitation and surgical planning.