Conservative Care Rivals Surgery for Cervical Radiculopathy

The Study at a Glance

Published in Spine, this systematic review compared surgery versus non-operative management for cervical radiculopathy. The authors (Kale KM et al., 2026) pooled data from over 1,100 patients and found no significant long-term differences between surgery and conservative care for arm pain, neck pain, or disability after 12+ months of follow-up.

What the Numbers Say

At short-term follow-ups (under 6 months), surgery appeared to provide faster relief. But by the 12-month mark and beyond, the gap closed entirely. Patients who chose physical therapy, chiropractic care, and other non-surgical approaches ended up with equivalent outcomes to those who went under the knife.

How It Works

Cervical radiculopathy happens when a nerve root in the neck is compressed or inflamed. Surgery (ACDF) directly removes the offending disc or bone spur. Conservative care reduces inflammation and improves spinal mechanics through chiropractic manipulation, physical therapy, and postural changes. Both paths support the body's natural healing through different mechanisms.

What This Means for Patients

Surgery is not a shortcut to better outcomes. Unless there is progressive neurological loss, a trial of 4 to 8 weeks of conservative care is a reasonable first step. If symptoms plateau and remain disabling despite good conservative care, surgery remains an option without fear that you waited too long.

Bottom Line

At 12+ months, surgery and conservative care produce equivalent outcomes for cervical radiculopathy. Patients can pursue non-surgical care first without compromising their long-term recovery.

Source: Spine, 2026 • Kale KM et al. • Systematic review of 1,100+ patients comparing surgery vs non-operative management for cervical radiculopathy

Need help? Dr. Monsalve treats patients with cervical radiculopathy at his Coral Gables / South Miami office. Call 305-209-4731.