In both presentations of acute and chronic neck pain, surgery is indicated when neurologic function is compromised (instability, spinal cord compression). The natural history of cervical radiculopathy is unknown. Few studies compare surgical and non-surgical management.
In patients with cervical radiculopathy without myelopathy, surgery is recommended if conservative treatment for 6-12 weeks is ineffective, there is progression of pain and dysfunction, and the MRI shows evidence of compression of the corresponding nerve root. The optimal timing of surgery is unclear.
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