{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T22:00:47Z","timestamp":1780696847876,"version":"3.54.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,11,23]],"date-time":"2020-11-23T00:00:00Z","timestamp":1606089600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Prospectively evaluate the clinical outcomes of acute cervical radiculopathy with respect to soft disc herniations vs osteophytes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Sixty consecutive patients who had had cervical radiculopathy for \u22641\u2009month were enrolled in the study. Inclusion criteria were radicular pain greater than axial pain and a pain score \u22654 out of 10 on a numerical rating scale. Patients had at least one positive clinical finding: motor, sensory, or reflex changes. Plain films and magnetic resonance imaging were ordered. Follow-up was at 6\u2009weeks and 3, 6, and 12\u2009months. Outcomes included pain scores (neck and upper limb), neck disability index, medication use, opioid use, and need for surgery. Two attending musculoskeletal radiologists reviewed imaging findings for osteophytes vs soft disc herniations at the symptomatic level.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>More than 75% reduction in pain was seen in 77% of patients with soft disc herniations and 66% of patients with osteophytes (P\u2009&amp;gt;\u20090.05) at 12\u2009months. A pain score \u22642 out of 10 within 6 to 12\u2009months was seen in 86% of patients with soft disc herniations and 81% of patients with osteophytes (P\u2009&amp;gt;\u20090.05). Moderate or marked improvement at 12\u2009months was seen in 85% of patients with soft discs and 77% of patients with osteophytes (P\u2009&amp;gt;\u20090.05). Baseline\u2013to\u201312-month numerical rating scale pain scores of patients with soft discs vs osteophytes had overlapping confidence intervals at each follow-up. At 12\u2009months, very few had undergone surgery (7% of patients with soft discs, 11% of patients with osteophytes; P\u2009&amp;gt;\u20090.05) or were on opioids (7% of patients with soft discs, 9% of patients with osteophytes; P\u2009&amp;gt;\u20090.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The majority of patients, but not all patients, with acute radiculopathies improved with time. This was seen with both soft disc herniations and osteophytes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pm\/pnaa341","type":"journal-article","created":{"date-parts":[[2020,9,19]],"date-time":"2020-09-19T04:34:41Z","timestamp":1600490081000},"page":"561-566","source":"Crossref","is-referenced-by-count":14,"title":["Acute Cervical Radiculopathy Outcomes: Soft Disc Herniations vs Osteophytes"],"prefix":"10.1093","volume":"22","author":[{"given":"William Jeremy","family":"Beckworth","sequence":"first","affiliation":[{"name":"Emory University, Emory Spine Center, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin A","family":"Abramoff","sequence":"additional","affiliation":[{"name":"Penn Medicine, Department of Rehab Medicine, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iain M","family":"Bailey","sequence":"additional","affiliation":[{"name":"Emory University, Department of Rehab Medicine, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sook","family":"Yoon","sequence":"additional","affiliation":[{"name":"Longstreet Clinic, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Umpierrez","sequence":"additional","affiliation":[{"name":"Emory Department of Radiology, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna","family":"Kakarala","sequence":"additional","affiliation":[{"name":"Emory Department of Radiology, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob Y","family":"Lee","sequence":"additional","affiliation":[{"name":"National Spine and Pain Centers, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A","family":"Ward","sequence":"additional","affiliation":[{"name":"National Spine and Pain Centers, USA"},{"name":"Emory University Rollins School of Public Health, Department of Biostatistics, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marly N","family":"Dows-Martinez","sequence":"additional","affiliation":[{"name":"Resurgeons Orthopedics, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S Tim","family":"Yoon","sequence":"additional","affiliation":[{"name":"Emory University, Emory Spine Center, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,11,23]]},"reference":[{"key":"2021031817230981200_pnaa341-B1","first-page":"1","volume-title":"Medical Management of Acute Cervical Radicular Pain: An Evidence-Based Approach","author":"Bogduk","year":"1999"},{"issue":"1","key":"2021031817230981200_pnaa341-B2","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/j.1468-1331.2008.02365.x","article-title":"Degenerative cervical radiculopathy: Diagnosis and conservative treatment. A review","volume":"16","author":"Kuijper","year":"2009","journal-title":"Eur J Neurol"},{"issue":"2","key":"2021031817230981200_pnaa341-B3","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1097\/00007632-199401001-00013","article-title":"Computed tomographic follow-up study of 21 cases of nonoperatively treated cervical intervertebral soft disc herniation","volume":"19","author":"Maigne","year":"1994","journal-title":"Spine (Phila Pa 1976)"},{"issue":"2","key":"2021031817230981200_pnaa341-B4","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1097\/00007632-199701150-00009","article-title":"The pathomorphologic changes that accompany the resolution of cervical radiculopathy. A prospective study with repeat magnetic resonance imaging","volume":"22","author":"Bush","year":"1997","journal-title":"Spine (Phila Pa 1976)"},{"issue":"6","key":"2021031817230981200_pnaa341-B5","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1054\/jocn.2000.0894","article-title":"The spontaneous resorption of herniated cervical discs","volume":"8","author":"Vinas","year":"2001","journal-title":"J Clin Neurosci"},{"issue":"6","key":"2021031817230981200_pnaa341-B6","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1097\/00007632-199903150-00021","article-title":"Outcome in patients with cervical radiculopathy. Prospective, multicenter study with independent clinical review","volume":"24","author":"Sampath","year":"1999","journal-title":"Spine (Phila Pa 1976)"},{"issue":"10","key":"2021031817230981200_pnaa341-B7","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1097\/00007632-198612000-00003","article-title":"Cervical radiculopathy. A review","volume":"11","author":"Dillin","year":"1986","journal-title":"Spine (Phila Pa 1976)"},{"issue":"7","key":"2021031817230981200_pnaa341-B8","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1097\/00007632-199704010-00007","article-title":"Long-lasting cervical radicular pain managed with surgery, physiotherapy, or a cervical collar. A prospective, randomized study","volume":"22","author":"Persson","year":"1997","journal-title":"Spine (Phila Pa 1976)"},{"issue":"5","key":"2021031817230981200_pnaa341-B9","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1097\/00002517-199912050-00008","article-title":"Herniated cervical intervertebral discs with radiculopathy: An outcome study of conservatively or surgically treated patients","volume":"12","author":"Heckmann","year":"1999","journal-title":"J Spinal Disord"},{"issue":"2","key":"2021031817230981200_pnaa341-B10","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1093\/brain\/117.2.325","article-title":"Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990","volume":"117","author":"Radhakrishnan","year":"1994","journal-title":"Brain"},{"key":"2021031817230981200_pnaa341-B11","doi-asserted-by":"crossref","first-page":"b3883","DOI":"10.1136\/bmj.b3883","article-title":"Cervical collar or physiotherapy versus wait and see policy for recent onset cervical radiculopathy: Randomised trial","volume":"339","author":"Kuijper","year":"2009","journal-title":"BMJ"},{"issue":"6","key":"2021031817230981200_pnaa341-B12","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.spinee.2010.02.007","article-title":"Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: The minimum clinically important difference and substantial clinical benefit after cervical spine fusion","volume":"10","author":"Carreon","year":"2010","journal-title":"Spine J"},{"issue":"6","key":"2021031817230981200_pnaa341-B13","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1302\/0301-620X.89B6.18712","article-title":"Observations on the natural history of massive lumbar disc herniation","volume":"89","author":"Cribb","year":"2007","journal-title":"J Bone Joint Surg Br"},{"issue":"5","key":"2021031817230981200_pnaa341-B14","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1007\/BF00588017","article-title":"Serial changes on MRI in lumbar disc herniations treated conservatively","volume":"37","author":"Matsubara","year":"1995","journal-title":"Neuroradiology"},{"issue":"7","key":"2021031817230981200_pnaa341-B15","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1097\/00007632-199007000-00013","article-title":"The natural history of lumbar intervertebral disc extrusions treated nonoperatively","volume":"15","author":"Saal","year":"1990","journal-title":"Spine (Phila Pa 1976)"},{"issue":"1","key":"2021031817230981200_pnaa341-B16","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.spinee.2017.08.264","article-title":"A minimum of 5-year follow-up after lumbar transforaminal epidural steroid injections in patients with lumbar radicular pain due to intervertebral disc herniation","volume":"18","author":"Kennedy","year":"2018","journal-title":"Spine J"},{"issue":"11","key":"2021031817230981200_pnaa341-B17","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1097\/00007632-199309010-00006","article-title":"The natural course of acute sciatica with nerve root symptoms in a double-blind placebo-controlled trial evaluating the effect of piroxicam","volume":"18","author":"Weber","year":"1993","journal-title":"Spine"},{"issue":"8","key":"2021031817230981200_pnaa341-B18","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.2106\/00004623-200608000-00005","article-title":"Nerve root blocks in the treatment of lumbar radicular pain. A minimum five-year follow-up","volume":"88","author":"Riew","year":"2006","journal-title":"J Bone Joint Surg Am"},{"issue":"11","key":"2021031817230981200_pnaa341-B19","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.2106\/00004623-200011000-00012","article-title":"The effect of nerve-root injections on the need for operative treatment of lumbar radicular pain. A prospective, randomized, controlled, double-blind study","volume":"82","author":"Riew","year":"2000","journal-title":"J Bone Joint Surg Am"},{"issue":"5","key":"2021031817230981200_pnaa341-B20","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1302\/0301-620X.79B5.0790804","article-title":"Foraminal injection for lateral lumbar disc herniation","volume":"79","author":"Weiner","year":"1997","journal-title":"J Bone Joint Surg Br"},{"issue":"3","key":"2021031817230981200_pnaa341-B21","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1111\/pme.12304","article-title":"The effectiveness and risks of fluoroscopically guided cervical transforaminal injections of steroids: A systematic review with comprehensive analysis of the published data","volume":"15","author":"Engel","year":"2014","journal-title":"Pain Med"}],"container-title":["Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/painmedicine\/article-pdf\/22\/3\/561\/36641120\/pnaa341.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/painmedicine\/article-pdf\/22\/3\/561\/36641120\/pnaa341.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T17:23:33Z","timestamp":1616088213000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/painmedicine\/article\/22\/3\/561\/5998484"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,23]]},"references-count":21,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,11,23]]},"published-print":{"date-parts":[[2021,3,18]]}},"URL":"https:\/\/doi.org\/10.1093\/pm\/pnaa341","relation":{},"ISSN":["1526-2375","1526-4637"],"issn-type":[{"value":"1526-2375","type":"print"},{"value":"1526-4637","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,3,1]]},"published":{"date-parts":[[2020,11,23]]}}}