Cervical spondylosis, or degeneration (wear and tear of the bones and discs in the neck), is a very common condition affecting most of us at some point in our lives. It is frequently related to strain of the supporting muscles or wear and tear of the discs that connect the individual bones (vertebrae) that form the spine, resulting in neck pain. Radiculopathy is pain, weakness or reduced reflexes that follow the path of nerves that come from the neck region. Myelopathy is spasticity and weakness in the lower limbs with or without "numb and clumsy" hands.
Most people with degeneration in the neck area may have no symptoms. In 10% to 15% of cases, the condition worsens to the extent that surgery is recommended. Surgery is aimed at improving these problems, but it is unclear which type of surgical procedure is best and how effective it is.
This review of two trials with 149 patients found no conclusive evidence to support surgical treatment for people with degeneration, radiculopathy or myelopathy. Possible limitations of this review include the the lack of large trials and the risk of bias associated with these studies. Further research is very likely to change the estimate of effects and our confidence in the results.
Future large-scale randomised trials with better methods are needed to provide clear evidence on the balance between risk and benefit from surgery for individuals with cervical degeneration with radiculopathy or myelopathy.