Both small trials had significant risks of bias and do not provide reliable evidence on the effects of surgery for cervical spondylotic radiculopathy or myelopathy. It is unclear whether the short-term risks of surgery are offset by long-term benefits. Further research is very likely to have an impact on the estimate of effect and our confidence in it.
There is low quality evidence that surgery may provide pain relief faster than physiotherapy or hard collar immobilization in patients with cervical radiculopathy; but there is little or no difference in the long-term.
There is very low quality evidence that patients with mild myelopathy feel subjectively better shortly after surgery, but there is little or no difference in the long-term.
Effects of different treatments on postural performance in patients with cervical root compression. A randomized prospective study assessing the importance of the neck in postural control.
Patients with cervical root compression were used as a "model" to investigate the possible importance of neck disorders and cervical sensory information in postural control. We assessed postural performance with posturography before and after treatment in 71 consecutive patients with MRI-verified cervical root compression without medullary compression. The patients were randomized to surgery (n = 22), physiotherapy (n = 24) or treatment with cervical collars (n = 25). There were no differences in postural performance or pain intensity between the groups before treatment. After treatment, the surgery group manifested significant improved postural performance and reduced neck pain scores, as compared to the two conservative treatment groups, and their postural performance had improved to the same level manifested by healthy controls. The conservative treatment groups manifested no consistent significant changes in postural performance or pain scores. Decreased muscular tension due to reduction of cervical pain after surgery and normalization of cervical proprioception are suggested as possible explanations of the improved postural control.