• Systematically reveals that synergistic imbalance of lumbar core muscles is a key pathological mechanism of intervertebral disc degeneration.
• Elucidates the mechanical-biological interaction mechanism, proposing the critical role of the Piezo1-YAP-nuclear factor E2-related factor 2/nuclear factor κB signaling axis in intervertebral disc degeneration.
• Proposes individualized intervention strategies based on synergistic functional reconstruction of muscle groups and a biomechanical marker system.
• Highlights the need for future research on neural regulatory mechanisms, sex-specific responses, and timing of intervention windows.