Friday, June 21, 2013 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.