From the Research
Management of Acute Severe Pain
The management of acute severe pain associated with cervical radiculopathy due to intervertebral disc protrusion (IVDP) and spondylosis involves both non-surgical and surgical approaches.
- Non-surgical treatments are recommended as an initial management, including comprehensive and aggressive management which often results in successful functional outcomes, pain reduction, and patient satisfaction 1.
- Surgery is applicable to patients with intractable or persistent pain despite sufficient conservative management or with severe or progressive neurological deficits 2, 3, 4.
Non-Surgical Treatment
Non-surgical treatment is the appropriate initial approach for most patients, with up to a 75% rate of spontaneous improvement 4.
- Non-surgical active and passive therapies can significantly improve symptoms in most patients 3.
- Conservative methods can result in complete or essential improvement of brachialgia, sensory disorders, and motor weakness in a significant percentage of patients 5.
Surgical Treatment
Surgical treatment options include anterior cervical decompression with fusion and posterior cervical laminoforaminotomy 3.
- Surgery is indicated for patients with clinically significant motor deficits, debilitating pain that is resistant to conservative modalities, or instability in the setting of disabling radiculopathy 3.
- Surgical outcomes for relief of arm pain range from 80% to 90% with either anterior or posterior approaches 4.
- Surgery may be necessary when nonsurgical treatment fails to relieve symptoms or if a significant neurologic deficit exists 4.