Observational studyEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
The CASINO trial: surgical versus conservative management in patients with cervical radiculopathy due to intervertebral disc herniation: a prospective cohort study.
Observational study in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Nonsurgical versus surgical treatment for cervical radiculopathy: a systematic review and meta-analysis of randomized controlled trials.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Pooled it
- Long-Term Comparative Outcomes of ACDF, Cervical Disc Arthroplasty, and Posterior Cervical Foraminotomy for Single-Level Cervical Radiculopathy: A Propensity-Matched Analysis.Global spine journal · 2026Article
- The prevalence of Type D personality and its association with clinical outcomes in patients with cervical radiculopathy after either conservative or surgical treatment.Frontiers in human neuroscience · 2026Article
- Does the Size of Cervical Disc Herniation Affect Clinical Parameters in Cervical Radiculopathy?Journal of clinical medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCervical Radicular Syndrome is predominantly treated conservatively, but surgical treatment can be considered after shared decision-making. Knowledge about difference in outcome is scarce. The CASINO trial aims to enhance this knowledge to assist patients and physicians in optimizing treatment choices.
methodsA multi-centre observational cohort study was conducted in patients visiting a neurologist or neurosurgeon with CRS and disc-herniation. Conservative and surgical treatment were discussed and in agreement a decision was made. 141 patients with cervical radiculopathy due to intervertebral disc herniations were included, 88 were surgically and 53 were conservatively treated. Visual Analogue Scale for arm pain and Neck Disability Index served as primary outcome parameters. Secondary outcome measures involved VAS neck pain and the EuroQol VAS. Data were collected at baseline, 6, 12, 26, 38, 52 and 104 weeks after inclusion, and analysed using linear mixed-effects models.
resultsAt baseline, the surgical treatment-arm had more arm pain (VAS Arm Pain, p =.017) but other baseline parameters were comparable. However, during the two years follow up period the surgical arm fared better than the conservatively treated patients: VAS arm pain decreased 12 mm more in the surgical group than in the conservative group (p =.053), exceeding the Minimal Clinical Important Difference (MCID). VAS neck pain decreased 19 mm more in the surgical group than in the conservative group (p =.002), illustrating a significant and clinically relevant difference between the treatment arms.
conclusionDuring two years follow up, differences could be substantiated between the two treatment arms regarding arm and neck pain.
Indexed as
Identifiers
40528016What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.