Surgery versus conservative care for neck pain: a systematic review

Middelkoop, Marienke van; Rubinstein, Sidney M.; Ostelo, R.W.J.G.; Tulder, Maurits W. van; Peul, Wilco C.; Koes, Bart W.; Verhagen, Arianne P.

doi:10.1007/s00586-012-2553-z

Cited by 42 publications

(31 citation statements)

References 23 publications

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“…As surgery is associated with a small but definite risk [6], conservative management is a suggested first treatment choice in the absence of serious neurological deficits [7, 8]. …”

Section: Introductionmentioning

confidence: 99%

Effectiveness of manual therapy for cervical radiculopathy, a review

Thoomes¹

2016

Chiropr Man Therap

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Manual therapy is often used for patients with neck pain with or without radicular symptoms. There is sparse evidence on the effectiveness in cervical radiculopathy. The aim of this study was to assess current levels of evidence on the effectiveness of manual therapy interventions for patients with cervical radiculopathy.Electronic data bases were systematically searched for clinical guidelines, reviews and randomised clinical trials (RCTs) reporting on the effectiveness of manual therapy for patients with cervical radiculopathy. Eight relevant reviews, two guidelines and two recent RCTs, that had not yet been included in either, were retrieved. The overall quality of the evidence of included studies was evaluated using the GRADE method. Most interventions were only studied in one single RCT.There is low level evidence that cervical manipulation and mobilisation as unimodal interventions are effective on pain and range of motion at the immediate follow up, but no evidence on the effectiveness of thoracic manipulation or mobilisation as unimodal interventions. There is low level evidence that a combination of spinal mobilisation and motor control exercises is more effective on pain and activity limitations than separate interventions or a wait-and-see policy. There is low level evidence of the effectiveness of cervical mobilisation with a neurodynamical intent as unimodal intervention, on the effectiveness of a multimodal intervention with neurodynamic intent on pain activity limitations and global perceived effect compared to a wait-and-see policy. There is also low level evidence that a multimodal intervention consisting of spinal and neurodynamic mobilisations and specific exercises is effective on pain in patients with CR. There is low level evidence that traction is no more effective than placebo traction.

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“…As surgery is associated with a small but definite risk [6], conservative management is a suggested first treatment choice in the absence of serious neurological deficits [7, 8]. …”

Section: Introductionmentioning

confidence: 99%

Effectiveness of manual therapy for cervical radiculopathy, a review

Thoomes¹

2016

Chiropr Man Therap

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“…No superior conservative treatment (42), or surgical treatment method (18) has been found, and there is a lack of evidence regarding the appropriate postoperative rehabilitation (43). Also, the current evidence does not show significant benefit of surgical treatment compared to conservative treatment (44). The clinical decision making process regarding when and which individuals to include for surgery for cervical degenerative disc disease cannot be made on evidence at this time.…”

Section: Management Of Cervical Degenerative Disc Diseasementioning

confidence: 66%

“…Despite these early differences, no significant differences in pain, disability or physical function between the surgically and conservatively treated groups were present at 15-month (57) or 2-year follow-ups (16,55). A number of review studies have found no clear benefits of surgical treatment compared to conservative treatment of neck pain with or without radiculopathy (44,58).…”

Section: Surgical Treatmentmentioning

confidence: 99%

Clinical and patient-reported outcomes after anterior cervical decompression and fusion surgery : A focus on functioning and daily life

Hermansen

2015

Linköping University Medical Dissertations

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“…The paper by van Middelkoop et al [20] published in January is a high-quality Cochrane systematic review investigating clinical trials on surgical treatment compared with conservative care in neck pain patients. A former Cochrane review based only on randomized trials had concluded that in the absence of pertinent data no conclusion could be provided on this subject.…”

Section: Surgery Versus Conservative Care For Neck Painmentioning

confidence: 99%

The Michel Benoist and Robert Mulholland Yearly European Spine Journal Review: a survey of the “medical” articles in the European Spine Journal, 2013

Benoist

2013

Eur Spine J

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Surgery versus conservative care for neck pain: a systematic review

Cited by 42 publications

References 23 publications

Effectiveness of manual therapy for cervical radiculopathy, a review

Effectiveness of manual therapy for cervical radiculopathy, a review

Clinical and patient-reported outcomes after anterior cervical decompression and fusion surgery : A focus on functioning and daily life

The Michel Benoist and Robert Mulholland Yearly European Spine Journal Review: a survey of the “medical” articles in the European Spine Journal, 2013

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