Surgical versus Nonsurgical Treatment for Cervical Radiculopathy.

Study Summary

One hundred eighty patients with cervical radiculopathy were randomized to receive either anterior cervical discectomy and fusion (surgery) or nonsurgical multidisciplinary care. Patients were stratified into two trials: disc herniation (n=89) and spondylosis (n=91). In the disc herniation trial, 45 received surgery and 44 nonsurgical care. In the spondylosis trial, 45 received surgery and 46 nonsurgical care. The primary outcome was the Neck Disability Index (NDI) at 12 months. Secondary outcomes included arm and neck pain (NRS), emotional distress, analgesic use, work absence, and patient-reported improvement. Outcomes were assessed at 3, 6, and 12 months. Overall, the results revealed that surgery was significantly more effective than nonsurgical treatment in improving NDI in patients with disc herniation, but not in those with spondylosis. These findings suggest that surgery may be more beneficial in disc herniation-related radiculopathy but not necessarily in spondylotic cases.