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    Study: Outcomes From Physical Therapy vs Surgery for Cervical Radiculopathy Similar After 2 Years (Spine. 2013 Jun 17. [Epub ahead of print])

    "Structured physiotherapy should be tried before surgery is chosen," concluded researchers of a study comparing surgery followed by physical therapy and physical therapy alone for cervical radiculopathy. Even though the results of the 24-month randomized controlled trial, published this week in Spine, showed greater improvement in the first postoperative year, the differences between the groups decreased after the second year. The study compared 2 approaches to cervical radiculopathy: anterior cervical decompression and fusion (ACDF) with a physical therapy program (31 subjects) and the same physical therapy program alone (32 subjects). The physical therapy program included general and specific exercises and pain coping strategies. Outcome measures were disability (Neck Disability Index, NDI), neck- and arm-pain intensity using a visual analog scale (VAS), and the patient's global assessment. At 12 months, there was no significant difference between groups for NDI or VAS for arm-pain intensity. The surgical group scored significantly better on the VAS for neck-pain intensity, and 87% of patients in the surgical group self-rated their symptoms as "better/much better" compared with 62% of those in the physical therapy-only group. However, at 24 months, both groups showed significant reduction in NDI, neck pain, and arm pain.

    Comments

    Was there a specific rehabilitation protocol that all of the patients received, with everyone receiving the same exercises? Or were programs individually tailored to each patient?
    Posted by Sylvie Le on 6/21/2013 6:57 PM
    I think this also means that the effect of surgery is negligible since both groups received PT!
    Posted by Baker on 6/24/2013 5:32 PM
    Actually, the study shows that effect of surgery was not negligible, and it is only at the two year mark that there is an equalization, so to speak. And two years is a long time when you consider the disabling effects of such an injury. And, the lasting psychological effects from loss of pleasure, productivity, income, independence, etc, from living with such a disabling problem for that long (as compared to those who had relief sooner) can also be significant. I think that is the real question to be answered.
    Posted by Dieringer on 6/24/2013 10:57 PM
    Dear Powersports Industries, I recently had a comment left on my blog (http://notesfromtheroad3.blogspot.co.uk/2012/08/top-10-north-american-motorcycle-rides.html) by "powersports" with a link to your site. Rather than a link from a comment, which is worth almost nothing and can even - in excess - negatively effect your site's rankings, I'd be happy to link to your site from within the content of my posts. Free of charge. I'd just want a link from one of your sites and/or blogs in return. If you're interested in any kind of link and/or guest blog exchange, just let me know. Thanks, Roy
    Posted by boots on 6/26/2013 10:36 PM
    The results here are typical for many types of injuries. Since surgery is rarely a quick fix, patients benefit to know that non-surgical treatments are often just as helpful. I think that, all too often, surgeons fail to impress upon their patients that rehab will take time either way. There really are no shortcuts.
    Posted by Rehab Orthopedic Medicine on 5/9/2014 5:15 PM
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