Cervical radicular pain: A randomised controlled trial comparing percutaneous plasma discectomy and anterior cervical discectomy.

Several treatments exist for the treatment of the cervical radicular syndrome
caused by a contained soft disc hernia. The effects of an open nucleotomy,
physiotherapy and cervical collar were studied by Persson (Feldborg Nielsen,
Annertz et al. 1997; Persson, Carlsson et al. 1997). They concluded that on the
short term pain improved much faster by surgery. On the long term muscle force,
sensibility and pain improved as well.
Kuijper (Kuijper, Tans et al. 2009; Kuijper, Tans et al. 2009) investigated the
effects of conservative treatment for the cervical radicular syndrome, and
concluded that a semi-hard cervical collar and rest for three to six weeks or
physiotherapy accompanied by home exercises for six weeks reduced neck and arm
pain substantially compared with a wait and see policy in the early phase of
cervical radiculopathy.
Cesaroni et al. (Cesaroni and Nardi 2009) studied percutaneous plasma
discectomy and found significantly better clinical outcomes than a conservative
care regimen.
Up till now no studies have been performed that compare the results of
percutaneous plasma discectomy with open nucleotomy.
Since the complications of open nucleotomy include a small risk on local
inflammation, local pain, and a longer period of convalescence, it would be
considered an important improvement, if the same advantages of open nucleotomy
could be achieved with percutaneous plasma discectomy being much less invasive.

The aim of this study is to compare the effects of anterior cervical discectomy
versus percutaneous plasma discectomy on pain, on global perceived effect,
functional status and health-related quality of life in a group of patients
with cervical radicular pain caused by a contained soft disc herniation.

A multicenter randomised controlled parallel-group study

Two different treatment methods will be compared in patients with a contained
disc hernia: anterior cervical discectomy and percutaneous plasma discectomy.

All two treatments are standard procedures in the participating treatment
centers, so the patients will undergo no additional treatment, and will not be
exposed to any additional risks by participating in the trial. The burden
associated with participation is that they will have to fill out a number of
online questionnaires, and undergo the following tests: Muscle strength; Upper
Limb Activity Monitor, Quantative Sensory Testing, and DNIC, at two regular
clinic visits (T0 and T2), and that they will have to make one extra visit to
the clinic to perform the same tests (T3).