Surgical versus Nonsurgical Treatment for Cervical Radiculopathy .
Surgical versus Nonsurgical Treatment for Cervical Radiculopathy.
NEJM Evid. 2025 Apr;4(4):EVIDoa2400404.A total of one hundred eighty patients with cervical radiculopathy due to either disc herniation (n=89) or spondylosis (n=91) were randomized to receive either surgical treatment with anterior cervical discectomy and fusion (n=90) or a multidisciplinary nonsurgical intervention (n=90). The primary outcome of interest was the change in the Neck Disability Index (NDI) score at 12 months. Secondary outcomes included arm and neck pain (Numeric Rating Scale), emotional distress, fear-avoidance beliefs, analgesic use, work absence, and patient-reported global improvement. Outcomes were assessed at baseline, 3, 6, and 12 months. Overall, the study revealed that surgery significantly improved NDI scores at 12 months for patients with disc herniation, but not for those with spondylosis. These findings suggest that surgery offers additional benefits over nonsurgical treatment only for disc herniation-related radiculopathy, with no apparent benefit for spondylosis-related cases.
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