• Anneli Peolsson, Anne Söderlund, Markus Engquist, Bengt Lind, Håkan Löfgren, Ludek Vavruch, Anders Holtz, Annelie Winström-Christersson, Ingrid Isaksson, and Birgitta Öberg.
• Department of Physiotherapy, Faculty of Health Sciences, Linköping University, Linköping, Sweden. anneli.peolsson@liu.se
• Spine. 2013 Feb 15;38(4):300-7.

Study DesignProspective randomized study.ObjectiveTo investigate differences in physical functional outcome in patients with radiculopathy due to cervical disc disease, after structured physiotherapy alone (consisting of neck-specific exercises with a cognitive-behavioral approach) versus after anterior cervical decompression and fusion (ACDF) followed by the same structured physiotherapy program.Summary Of Background DataNo earlier studies have evaluated the effectiveness of a structured physiotherapy program or postoperative physical rehabilitation after ACDF for patients with magnetic resonance imaging-verified nerve compression due to cervical disc disease.MethodsOur prospective randomized study included 63 patients with radiculopathy and magnetic resonance imaging-verified nerve root compression, who were randomized to receive either ACDF in combination with physiotherapy or physiotherapy alone. For 49 of these patients, an independent examiner measured functional outcomes, including active range of neck motion, neck muscle endurance, and hand-related functioning before treatment and at 3-, 6-, 12-, and 24-month follow-ups.ResultsThere were no significant differences between the 2 treatment alternatives in any of the measurements performed (P = 0.17-0.91). Both groups showed improvements over time in neck muscle endurance (P ≤ 0.01), manual dexterity (P ≤ 0.03), and right-handgrip strength (P = 0.01).ConclusionCompared with a structured physiotherapy program alone, ACDF followed by physiotherapy did not result in additional improvements in neck active range of motion, neck muscle endurance, or hand-related function in patients with radiculopathy. We suggest that a structured physiotherapy program should precede a decision for ACDF intervention in patients with radiculopathy, to reduce the need for surgery.Level Of Evidence2.

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