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The Stabilizing System of the Spine-Manohar M. Panjabi

The Stabilizing System of the Spine. Part I. Function, Dysfunction, Adaptation, and Enhancement-Manohar M. Panjabi

The spinal stabilizing system consists ofthree subsystems. The vertebrae, discs, and ligaments
constitute the passive subsystem. All muscles and tendons surrounding the spinal
column that can apply forces to the spinal column constitute the active subsystem.
The nerves and central nervous system comprise the neural subsystem, which
determines the requirements for spinal stability by monitoring the various trans-
ducer signals, and directs the active subsystem to provide the needed stability.

A dysfunction of a component of any one of the subsystems may lead to one or more
of the following three possibilities: (a) an immediate response from other subsys-
tems to successfully compensate, (b) a long-term adaptation response of one or
more subsystems, and (c) an injury to one or more components of any subsystem.

It is conceptualized that the first response results in normal function, the second
results in normal function but with an altered spinal stabilizing system, and the
third leads to overall system dysfunction, producing, for example, low back pain.
In situations where additional loads or complex postures are anticipated, the
neural control unit may alter the muscle recruitment strategy, with the temporary
goal of enhancing the spine stability beyond the normal requirements.