Abstract Details

Title Surgical Versus Nonsurgical Treatment for Cervical Radiculopathy: A Systematic Review and Meta-analysis

Topic Pain

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 14-004

Objective To systematically compare the effectiveness of surgical and non-surgical management for cervical radiculopathy on patient-reported outcomes, including functional disability, pain, and global improvement.

Background Cervical radiculopathy is the second most common radiculopathy, causing significant neck and radiating arm pain. While both surgical and conservative treatments are used, a discussion about their comparative long-term effectiveness on functional and pain-related outcomes remains ongoing.

Design/Methods We systematically searched PubMed, Scopus, and Cochrane Central Register of Controlled Trials for comparative studies. Eligible studies included patients diagnosed with CR undergoing surgical intervention (like ACDF) or non-surgical management (like physiotherapy). The primary outcome was the Neck Disability Index (NDI). Secondary outcomes included Visual Analog Scale (VAS) scores for arm and neck pain, and patient-reported improvement rates. Data were pooled using a random-effects model.

Results Five studies (N=318 patients) met the inclusion criteria. The meta-analysis showed that surgical intervention led to statistically significant greater reductions in both arm pain (MD: -1.25, 95% CI: -1.71 to -0.78) and neck pain (MD: -0.84, 95% CI: -1.35 to -0.32) compared to non-surgical procedures. Patients in the surgical group were 33% more likely to report feeling "better" or "much better" (RR: 1.33, 95% CI: 1.07 to 1.65). For functional recovery (NDI), no significant difference was found at short-term (12-month) follow-up. However, a single long-term study (5-8 years) showed a clinically meaningful advantage for surgery.

Conclusions This study suggests that surgery provides more significant benefits for pain relief than non-surgical strategies. The potential for superior functional recovery appears to emerge only in the long term, but this conclusion is based on limited evidence. Therefore, while surgery is an effective option, careful patient selection and shared decision-making are essential for optimizing individual outcomes.

Authors/Disclosures
Sharvani Gurupadayya Salimath, MD PRESENTER	Dr. Salimath has nothing to disclose.
Shams S. Albarari	Shams S. Albarari has nothing to disclose.
Noon Elimam, MBBS	Dr. Elimam has nothing to disclose.
Yara Shaalan (Misr University for Science and Technology)	Ms. Shaalan has nothing to disclose.
Rahaf Mogahed, MD	Dr. Mogahed has nothing to disclose.
Nourhan M. Elmekkawi III, MD	Dr. Elmekkawi has nothing to disclose.
Arwa A. Mostafa, MBBS	Dr. Mostafa has nothing to disclose.
Eman Fathy, MD	Dr. Fathy has nothing to disclose.
Rewan R. Asr	Dr. Asr has nothing to disclose.
Ainaa A. Alzamari, MD	Dr. Alzamari has nothing to disclose.

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