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Surgery often is considered for patients with cervical radiculopathy who have intractable pain or progressive neurological deficits. However, surgical and nonsurgical management have been compared directly in only a few small, randomized trials.
For this Norwegian trial, researchers enrolled 180 patients — mostly middle-aged adults — who had disabling radicular arm pain for at least 3 months, neck pain, and radiologic documentation of cervical nerve root compression by herniated disc (89 patients) or cervical spondylosis (91 patients); patients with myelopathy were excluded. Participants were randomized to surgery or nonsurgical treatment (i.e., physical therapy and cognitive behavioral support).
Findings at 12 months were as follows:
Among pa…