Gebreyohanes, Axumawi;
Erotocritou, Marios;
Choi, David;
(2022)
Appraising The Evidence for Conservative versus Surgical Management of Motor Deficits in Degenerative Cervical Radiculopathy.
Global Spine Journal
, Article 21925682221109562. 10.1177/21925682221109562.
(In press).
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Abstract
STUDY DESIGN: Systematic review. OBJECTIVES: Understanding the prevalence and outcome of motor deficits in degenerative cervical radiculopathy is important to guide management. We compared motor radiculopathy outcomes after conservative and surgical management, a particular focus being painful vs painless radiculopathy. METHODS: MEDLINE and EMBASE databases were searched. We stratified each study cohort into 1 of 6 groups, I-VI, based on whether radiculopathy was painful, painless or unspecified, and whether interventions were surgical or non-surgical. RESULTS: Of 10 514 initial studies, 44 matched the selection criteria. Whilst 42 (95.5%) provided baseline motor radiculopathy data, only 22 (50.0%) provided follow-up motor outcomes. Mean baseline prevalence of motor deficits was 39.1% (9.2%-73.3%) in conservative cohorts and 60.5% (18.5%-94.1%) in surgical cohorts. Group VI, 'surgically-managed motor radiculopathy with unclear pain status' had the largest number of cohorts. Conversely, no cohorts were found in Group III, 'conservatively-managed painless motor radiculopathy'. Large disparities in data quality made direct comparison of conservative vs operative management difficult. CONCLUSIONS: Overall pre-intervention prevalence of motor deficits in degenerative cervical radiculopathy is 56.4%. Many studies fail to report motor outcomes after intervention, meaning statistical evidence to guide optimal management of motor radiculopathy is currently lacking. Our study highlights the need for more evidence, preferably from a prospective long-term study, to allow direct comparisons of motor outcomes after conservative and surgical management.
| Type: | Article |
|---|---|
| Title: | Appraising The Evidence for Conservative versus Surgical Management of Motor Deficits in Degenerative Cervical Radiculopathy |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/21925682221109562 |
| Publisher version: | https://doi.org/10.1177%2F21925682221109562 |
| Language: | English |
| Additional information: | https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Clinical Neurology, Orthopedics, Neurosciences & Neurology, degenerative disc disease, degenerative cervical radiculopathy, motor radiculopathy, motor outcomes, POSTERIOR FORAMINOTOMY, UNILATERAL RADICULOPATHY, ANTERIOR DISKECTOMY, STEROID INJECTIONS, INTERBODY FUSION, DISC HERNIATION, DECOMPRESSION, PAIN, STABILIZATION, OUTCOMES |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Brain Repair and Rehabilitation UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10151351 |
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