Physical therapy alone is better than Neck surgery for disc disease

In patients with radiculopathy due to cervical disc disease, anterior cervical decompression and fusion (ACDF) followed by physical therapy did not result in additional improvements in neck active range of motion, neck muscle endurance, or hand-related function compared with a structured physical therapy program alone, say authors of an article published this month in Spine. They suggest that a structured physical therapy program should precede a decision for ACDF intervention in patients with radiculopathy to reduce the need for surgery.

In this prospective randomized study, 63 patients with radiculopathy and magnetic resonance imaging-verified nerve root compression received either ACDF in combination with physical therapy or physical therapy alone. Outcomes, including active range of neck motion, neck muscle endurance, and hand-related functioning, were measured in 49 of these patients by an independent examiner before treatment and at 3-, 6-, 12-, and 24-month follow-ups.

There were no significant differences between the 2 treatment alternatives in any of the measurements performed. Both groups showed improvements over time in neck muscle endurance, manual dexterity, and right-handgrip strength.