SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2026
Nonsurgical versus surgical treatment for cervical radiculopathy: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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13 authors.
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Abstract
purposeThere is conflicting evidence regarding the optimal management strategy for cervical radiculopathy. We conducted a meta-analysis to evaluate the relative effectiveness of nonsurgical treatment and surgical care in adult patients with cervical radiculopathy.
methodsWe systematically searched PubMed, Embase, and the Cochrane Library to identify randomized controlled trials (RCTs) comparing nonsurgical treatment with surgical treatment. All statistical analyses were performed using RevMan version 5.4.
resultsFive RCTs met the inclusion criteria. Surgical treatment significantly improved neck pain (SMD 0.70, 95% CI 0.15–1.26) and arm pain (SMD 0.62, 95% CI 0.04–1.19) compared with non-surgical care. Subgroup analysis showed that benefits for neck pain were most pronounced in patients with disc herniation (SMD 1.02, 95% CI 0.11–1.93) and in those with unspecified pathology (SMD 1.23, 95% CI 0.69–1.77), whereas benefits for arm pain were observed only in disc herniation (SMD 1.29, 95% CI 0.90–1.68). Surgical treatment also improved physical function (SMD 0.33, 95% CI 0.06–0.59) but did not significantly affect emotional/mood outcomes (SMD 0.22, 95% CI − 0.02 to 0.45), patient-reported overall improvement (RR 0.97, 95% CI 0.72–1.31), or analgesic use (RR 1.03, 95% CI 0.77–1.36).
conclusionsSurgical management of cervical radiculopathy may provide superior improvements in neck and arm pain, as well as functional outcomes, compared with non-surgical treatment, particularly in patients with disc herniation. Further high-quality trials are warranted to confirm these findings and define optimal patient selection.
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