Chinese Journal of Tissue Engineering Research ›› 2026, Vol. 30 ›› Issue (24): 6220-6224.doi: 10.12307/2026.138

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Correlation between cervical instability and neck muscle changes in middle-aged and young adults#br#
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Lu Guangqi, Li Jing, Sun Xinyue, Liang Long, Liu Guangwei, Zhou Shuaiqi, Mao Hanze, Ma Mingming, Cui Ying, Liu Yakun, Hu Jiaming, #br# Zhu Liguo, Yu Jie, Zhuang Minghui#br#   

  1. Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China
  • Received:2025-03-21 Revised:2025-07-31 Online:2026-08-28 Published:2026-01-29
  • Contact: Yu Jie, Chief physician, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China Co-corresponding author: Zhuang Minghui, Attending physician, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China
  • About author:Lu Guangqi, PhD candidate, Physician, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China
  • Supported by:
    Special Project on Clinical Evidence-Based Research in Traditional Chinese Medicine for the High-Level Traditional Chinese Medicine Hospital Construction Project of Wangjing Hospital, China Academy of Traditional Chinese Medicine, No. WJYY-XZKT-2023-01 (to YJ); National Natural Science Foundation of China (General Program), Nos. 82274560 and 82074455 (both to YJ); National Natural Science Foundation of China (Youth Project), No. 82405438 (to ZMH); Self-selected Special Topic Project of Wangjing Hospital, China Academy of Traditional Chinese Medicine, No. WJYY-XZKT-2023-24 (to ZMH)

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Abstract: BACKGROUND: The onset of cervical instability in middle-aged and young adults often begins with neck muscle injuries. A deeper understanding of changes in neck muscles during cervical instability and their correlation can provide valuable data to support the prevention and treatment of cervical instability in this population. 
OBJECTIVE: To explore the correlation between cervical instability and neck muscle changes in middle-aged and young adults. 
METHODS: A total of 98 patients with cervical C4/5 instability and 88 healthy subjects, aged 18-45 years, were enrolled through recruitment advertisements and the Department of Spine, Wangjing Hospital, China Academy of Traditional Chinese Medicine. Cervical X-rays were collected to measure cervical curvature and C4/5 vertebral angular displacement. Cervical magnetic resonance imaging was taken to obtain data on C4/5 intervertebral disc signal intensity, as well as the relative cross-sectional area and fat ratio of neck muscles, including prevertebral muscles, deep posterior cervical muscles, and superficial muscles. A univariate intergroup comparison of X-ray and magnetic resonance imaging data was conducted between cervical instability subjects and healthy controls, along with Spearman correlation analysis between C4/5 angular displacement and disc signal intensity, relative cross-sectional area of neck muscles and fat percentage at the C4/5 level in cervical instability subjects.
RESULTS AND CONCLUSION: The age, C4/5 horizontal displacement, C4/5 angular displacement and the percentage of fat in the deep posterior cervical muscles in the cervical spine instability group were greater than those in the healthy group (P < 0.05), and the cervical curvature and the relative cross-sectional area of the deep posterior cervical muscles were smaller than those in the healthy group (P < 0.05). Spearman’s correlation analysis showed that there was a negative correlation between the C4/5 angular displacement and the relative cross-sectional area of the deep posterior cervical muscles (P < 0.05). These findings suggest that changes in the deep posterior cervical muscles may be closely associated with cervical instability in middle-aged and young adults.

Key words: cervical instability, neck muscles, muscle cross-sectional area, fat ratio, middle-aged and young adults, cervical spondylosis

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