Studies Can't Prove Benefits of Surgery for Cervical Spondylosis

Contact: Megan KellerLippincott Williams & Wilkins(215) 521-8374[email protected]

EMBARGO DATE APRIL 1, 2002

Studies Can't Prove Benefits of Surgery for Cervical Spondylosis

PHILADELPHIA, PA April 1, 2002 - The few scientifically controlled studies performed to date show no advantage of surgery over nonsurgical treatment for patients with symptoms caused by degeneration of the vertebrae in the neck (cervical spondylosis), according to a report in the April 1 issue of the journal Spine.

Led by Ioannis P. Fouyas, Ph.D., researchers at University of Edinburgh performed an extensive medical literature review to identify all studies of surgery for cervical spondylosis. Focusing on the best available scientific data, the reviewers included only studies that randomly assigned patients to surgery or medical treatment and were "truly unconfounded" - that is, controlled for other factors possibly influencing the results.

Of more than 13,000 articles screened, only two studies - including a total of 130 patients - met the scientific criteria.

One study assigned 81 patients to surgery, physical therapy, or immobilization in a cervical collar for patients with cervical spondylosis affecting the spinal nerve roots (radiculopathy). In the short term, surgery was more effective in reducing pain, weakness, and numbness. One year later, however, the results were not significantly different for patients who had surgery versus nonsurgical treatments.

The other study included 49 patients for cervical spondylosis causing symptoms related to the spinal cord itself (myelopathy). At two years' follow-up, the results were similar for patients treated with or without surgery.

Patients with cervical spondylosis have neck pain and stiffness, and sometimes numbness and weakness in the arms and legs, caused by pressure on either the spine itself or the major nerve roots coming off the spine. Surgery may be performed for patients with persistent or severe symptoms. However, surgery carries small but definite risks of complications.

The literature review sought to define the true risks and benefits of surgery for cervical spondylosis. However, the few small studies performed so far do not provide enough valid scientific evidence to determine the effectiveness of surgery.

Dr. Fouyas and colleagues conclude, "It is not clear whether the short-term risks of surgery are offset by any long-term benefits." They call for larger, well-designed scientific studies of surgery for cervical spondylosis, including random treatment assignments and reliable tools for measuring the treatment results.

Recognized internationally as the leading journal in its field, Spine reports on today's most important diagnostic and therapeutic advances regarding spinal pain, deformity, and disability. Distinguished by its broad scope of coverage and emphasis on patient care, this popular biweekly has earned must-read status in the orthopaedic community. For more information, call 1-800-638-3030 or visit www.spinejournal.com.

Lippincott Williams & Wilkins (www.LWW.com) is a global publisher of medical, nursing and allied health information resources in book, journal, newsletter, looseleaf, and electronic media formats.

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