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- Engquist, M. (author)
A 5-to 8-year randomized study on the treatment of cervical radiculopathy: anterior cervical decompression and fusion plus physiotherapy versus physiotherapy alone
- Article/chapterEnglish2017
Publisher, publication year, extent ...
- Journal of Neurosurgery Publishing Group (JNSPG),2017
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- LIBRIS-ID:oai:gup.ub.gu.se/250100
- https://gup.ub.gu.se/publication/250100URI
- https://doi.org/10.3171/2016.6.spine151427DOI
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- Language:English
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- OBJECTIVE The aim of this study was to evaluate the 5- to 8-year outcome of anterior cervical decompression and fusion (ACDF) combined with a structured physiotherapy program as compared with that following the same physiotherapy program alone in patients with cervical radiculopathy. No previous prospective randomized studies with a follow-up of more than 2 years have compared outcomes of surgical versus nonsurgical intervention for cervical radiculopathy. METHODS Fifty-nine patients were randomized to ACDF surgery with postoperative physiotherapy (30 patients) or to structured physiotherapy alone (29 patients). The physiotherapy program included general and specific exercises as well as pain coping strategies. Outcome measures included neck disability (Neck Disability Index [NDI]), neck and arm pain intensity (visual analog scale [VAS]), health state (EQ-5D questionnaire), and a patient global assessment. Patients were followed up for 5-8 years. RESULTS After 5-8 years, the NDI was reduced by a mean score% of 21 (95% CI 14-28) in the surgical group and 11% (95% CI 4%-18%) in the nonsurgical group (p = 0.03). Neck pain was reduced by a mean score of 39 mm (95% CI 26-53 mm) compared with 19 mm (95% CI 7-30 mm; p = 0.01), and arm pain was reduced by a mean score of 33 mm (95% CI 18-49 mm) compared with 19 mm (95% CI 7-32 mm; p = 0.1), respectively. The EQ-5D had a mean respective increase of 0.29 (95% CI 0.13-0.45) compared with 0.14 (95% CI 0.01-0.27; p = 0.12). Ninety-three percent of patients in the surgical group rated their symptoms as "better" or "much better" compared with 62% in the nonsurgical group (p = 0.005). Both treatment groups experienced significant improvement over baseline for all outcome measures. CONCLUSIONS In this prospective randomized study of 5- to 8-year outcomes of surgical versus nonsurgical treatment in patients with cervical radiculopathy, ACDF combined with physiotherapy reduced neck disability and neck pain more effectively than physiotherapy alone. Self-rating by patients as regards treatment outcome was also superior in the surgery group. No significant differences were seen between the 2 patient groups as regards arm pain and health outcome.
Subject headings and genre
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine hsv//eng
- cervical radiculopathy
- randomized
- surgery
- physiotherapy
- anterior cervical decompression and
- neck-disability-index
- interbody fusion
- disc disease
- follow-up
- nonsurgical treatment
- diskectomy
- surgery
- reliability
- myelopathy
- validity
- Neurosciences & Neurology
- Surgery
Added entries (persons, corporate bodies, meetings, titles ...)
- Lofgren, H. (author)
- Oberg, B. (author)
- Holtz, A. (author)
- Peolsson, A. (author)
- Soderlund, A. (author)
- Vavruch, L. (author)
- Lind, Bengt,1948Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics(Swepub:gu)xlbene (author)
- Lifornia, V. P. (author)
- Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för ortopedi (creator_code:org_t)
Related titles
- In:Journal of Neurosurgery-Spine: Journal of Neurosurgery Publishing Group (JNSPG)26:1, s. 19-271547-5654
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- Engquist, M.
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- MEDICAL AND HEALTH SCIENCES
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- University of Gothenburg
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