Spinal fusion, physiotherapy vs. physiotherapy for radiculopathy: 7 key factors in favor of surgery


A new study published in Spine examines the outcomes for patients with anterior cervical decompression and fusion with physiotherapy to patients who have physiotherapy alone to treat cervical radiculopathy.

The study was a prospective randomized controlled trial including 60 patients with cervical radiculopathy. The patients were randomized to either ACDF and physiotherapy or physiotherapy alone treatment.


The factors that altered treatment in favor of surgery were:


• Neck pain less than 12 months
• Arm pain less than 12 months
• Female sex
• Low EQ-5D index
• High anxiety levels because of the neck/arm pain
• Low Self-Efficacy Scale score
• High Distress Risk Assessment Method score


There weren't any factors associated with better outcomes among the patients who underwent physiotherapy alone.


The patient's age, smoking status, preoperative pain levels, disc herniation type and number of levels decompressed didn't have an impact on the outcomes between surgical and non-surgical treatment.


"A better treatment outcome can be expected when surgery, if needed, is performed within a year from the onset of cervical radiculopathy symptoms," concluded the study authors.


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