Each year, numerous people are subjected to spinal surgery -- a costly and risky procedure -- for cervical spondylosis, a degenerative disc condition that can cause severe pain or even loss of muscle function. Yet, there is no valid scientific evidence that those operations are any more effective than non-surgical treatments.

A research team from the University of Edinburgh, headed by Aeneas P. Fouyas, Ph.D., reached that conclusion after performing an extensive medical literature review to identify all studies of surgery for cervical spondylosis. Focusing on the best available scientific data, the reviewers included only studies that randomly assigned patients to surgery or medical treatment and were "truly unconfounded," that is, controlled for other factors possibly influencing the results.

Their report, published in the April 1, 2002 issue of the journal Spine, noted that, of more than 13,000 articles screened, only two studies -- including a total of 130 patients -- met the scientific criteria.

One study assigned 81 patients to surgery, physical therapy, or immobilization in a cervical collar for patients with cervical spondylosis affecting the spinal nerve roots (radiculopathy). In the short term, surgery was more effective in reducing pain, weakness, and numbness. One year later, however, the results were not significantly different for patients who had surgery versus nonsurgical treatments.

The other study included 49 patients for cervical spondylosis causing symptoms related to the spinal cord itself (myelopathy). At two years' follow-up, the results were similar for patients treated with or without surgery.

After studying all the research available, Dr. Fouyas and hid colleagues concluded, "It is not clear whether the short-term risks of surgery are offset by any long-term benefits."

In the United States, cervical spondylosis is a common condition, accounting for about two percent of all hospital admissions. According to Hassan A. Al-Shatoury, M.S.c, Research Fellow, Department of Neurosurgery, University of Illinois at Chicago, more than 90% of all males over age 50, and 90% of females over age 60, have some evidence of degenerative changes in the cervical spine due to normal aging process.

SOURCES: "Cochrane Review on the Role of Surgery in Cervical Spondylotic Radiculomyelopathy," Aeneas P. Fouyas, Ph.D., Spine, Apr. 1, 2002.