For his thesis to Sahlgrenska Academy at the University of Gothenburg, postgraduate student Markus Engquist studied 63 patients suffering from a disc herniation in the neck and compared the effect of the treatment that was offered: either an operation followed by physiotherapy or physiotherapy alone.
The studies showed that patients who have neck and arm pain as a result of a disc herniation or osteophytes from adjacent joints are most satisfied later if they had surgery.
“When we monitored the patients who had underwent surgery after 5 to 8 years, 93 per cent thought that they were better, in terms of both pains in the neck and perceived function level. Among those who received physiotherapy alone, 62 per cent thought that they were better than before treatment,” says Markus Engquist, a consultant at the orthopaedic clinic in Jönköping.
An operation as treatment for a disc herniation in the neck is normal all over the world. In spite of this, Markus Engquist’s study is the first to compare the benefits of an operation with a structured non-surgical treatment.
Best result with quick operation
In a follow-up study, the researchers in Gothenburg have mapped the factors that can identify which patients would gain the most benefit from an operation. Among other things, it was found that the results are better if the operation is performed within a year after the first symptoms appear.
“A reasonable conclusion from our results would be that treatment for a disc herniation the neck should begin with a structured physiotherapy programme, but that those with the greatest remaining difficulties after about three months should be offered an operation within a couple of months,” says Markus Engquist.
The thesis Surgery versus nonsurgical treatment of cervical radiculopathy is being defended on 23 October.
FACTS ABOUT AN OPERATION AND PHYSIOTHERAPY
In an operation for cervical radiculopathy, so-called anterior cervical decompression is normally performed in which disc hernias or osteophytes that are pressing on nerve structures are removed and arthrodesic fusion is performed. This treatment is followed by physiotherapy for the purpose of regaining movement and function.
Markus Engquist, postgraduate student at the Sahlgrenska Academy, University of Gothenburg
Principal supervisor Associate Professor Bengt Lind, Gothenburg, [email protected]
BY: Krister Svahn