{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:32:24Z","timestamp":1789014744913,"version":"build-2803163510"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Spine J"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Cervical Radicular Syndrome is predominantly treated conservatively, but surgical treatment can be considered after shared decision-making. Knowledge about difference in outcome is scarce. The CASINO trial aims to enhance this knowledge to assist patients and physicians in optimizing treatment choices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multi-centre observational cohort study was conducted in patients visiting a neurologist or neurosurgeon with CRS and disc-herniation. Conservative and surgical treatment were discussed and in agreement a decision was made. 141 patients with cervical radiculopathy due to intervertebral disc herniations were included, 88 were surgically and 53 were conservatively treated. Visual Analogue Scale for arm pain and Neck Disability Index served as primary outcome parameters. Secondary outcome measures involved VAS neck pain and the EuroQol VAS. Data were collected at baseline, 6, 12, 26, 38, 52 and 104 weeks after inclusion, and analysed using linear mixed-effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, the surgical treatment-arm had more arm pain (VAS Arm Pain,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=.017) but other baseline parameters were comparable. However, during the two years follow up period the surgical arm fared better than the conservatively treated patients: VAS arm pain decreased 12\u00a0mm more in the surgical group than in the conservative group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=.053), exceeding the Minimal Clinical Important Difference (MCID). VAS neck pain decreased 19\u00a0mm more in the surgical group than in the conservative group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=.002), illustrating a significant and clinically relevant difference between the treatment arms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>During two years follow up, differences could be substantiated between the two treatment arms regarding arm and neck pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00586-025-09045-y","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T21:16:54Z","timestamp":1750195014000},"page":"3398-3407","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The CASINO trial: surgical versus conservative management in patients with cervical radiculopathy due to intervertebral disc herniation: a prospective cohort study"],"prefix":"10.1007","volume":"34","author":[{"given":"Azra","family":"G\u00fcl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarita","family":"van Geest","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Kuijper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton Adriaan","family":"van der Plas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewout","family":"Steyerberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Vleggeert-Lankamp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,18]]},"reference":[{"issue":"Pt 2","key":"9045_CR1","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1093\/brain\/117.2.325","volume":"117","author":"K Radhakrishnan","year":"1994","unstructured":"Radhakrishnan K, Litchy WJ, O\u2019Fallon WM, Kurland LT (1994) Epidemiology of cervical radiculopathy. 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Written informed consent was obtained from all patients. Additional informed consent was obtained from all individual participants for whom identifying information is included in this article. The study was registered July 3, 2012 in the Netherlands, Dutch Trial Register Number: NTR1289.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics statement, informed consent and consent to publish"}},{"value":"The authors have no personal, financial, or institutional interest in any of the materials of devices described in this article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}