Quote:
Originally Posted by kean
Can anyone point me to any literature/studies showing that people who have had surgeries/fusions get NO better results than people who have had physical therapy? My wife is contemplating recommendations for 3 level acdf c4-7 with a bulging discs at c3. We are concerned this could be the first of potentially many surgery if we agree to have this first one.
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Hi Kean, Welcome.
IMO your concerns are valid & well-founded/justified.
While not directly related, in looking/searching for answers to your query I came across the best answer I've ever read to one of the most common questions we get on this forum—"Should I get surgery?"—in the form of a study abstract. It is, IMO,
SO good that I'm going to quote it here and save it for future reference.
Quote:
Cervical spondylotic myelopathy and radiculopathy are common disorders which can lead to significant clinical morbidity. Conservative management, such as physical therapy, cervical immobilisation, or anti-inflammatory medications, is the preferred and often only required intervention. Surgical intervention is reserved for those patients who have intractable pain or progressive neurological symptoms. The goals of surgical treatment are decompression of the spinal cord and nerve roots and deformity prevention by maintaining or supplementing spinal stability and alleviating pain. Numerous surgical techniques exist to alleviate symptoms, which are achieved through anterior, posterior, or circumferential approaches. Under most circumstances, one approach will produce optimal results. It is important that the surgical plan is tailored to address each individual's unique clinical circumstance.
http://www.hindawi.com/journals/aop/2012/919153/
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Now back to the original question, I found this article:
Physical Therapy or Neck Surgery?
This is the study referenced in the above article:
Surgery Versus Nonsurgical Treatment of Cervical Radiculopathy: A Prospective, Randomized Study Comparing Surgery Plus Physiotherapy With Physiotherapy Alone With a 2-Year Follow-up.
http://www.ncbi.nlm.nih.gov/pubmed/23778373
Quote:
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CONCLUSION.: In this prospective, randomized study of patients with cervical radiculopathy, it was shown that surgery with physiotherapy resulted in a more rapid improvement during the first postoperative year, with significantly greater improvement in neck pain and the patient's global assessment than physiotherapy alone, but the differences between the groups decreased after 2 years. Structured physiotherapy should be tried before surgery is chosen. Level of Evidence: 2.
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Others may be cited in posts here—try Searching the archives—on PubMed, the various medical journals (JAMA, BMJ, The Lancet, etc.) and elsewhere. On Goggle, it sometimes helps to preface search criteria with the words "scholarly" or "study".
Hope this helps,
Doc