c-spine outcome2

– there was no mention of the complications that the surgical patients endured.

– they concluded that half of patients continued to have neurologic symptoms, and that the statistically significant improvement was only seen in the surgical group (though the medical group did improve). The fact that many did not improve suggested to the authors that they were not dealt with soon enough, and that surgery should have been offered sooner – pretty far stretching conclusion.

In the end, it is really difficult to derive much from this study. How to treat the individual who shows up with a cervical radiculopathy? Surgery or medical treatment? Because the two groups were different to begin with and no randomization was performed, it is difficult to compare the results between the two groups! Sure, they showed an improvement in the surgical group, but the indications for surgery were not listed, and so it is difficult to know how to apply these observations.
They did, however, indicate that a significant number of surgical patients (over 25%) continue to have severe pain – they offer no explanation for this.

So, if the question is “how do I treat patients with cervical radiculopathy?” it is difficult to say that this paper offers much help in answering that….

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