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The natural course of symptomatic cervical degenerative disease is unclear, mainly because no good quality, prospective cohort studies of untreated patients have been conducted. However, the available observational data show that progressive disability is not inevitable, that symptoms might remain static, and patients with apparent disability might improve without surgery. Patients with radicular symptoms do not necessarily progress to develop overt myelopathy, and in one study at five years, 75% had improved spontaneously. A small randomised controlled trial also found that outcomes after surgery might be similar to those of conservative management. Possible complications of surgery include oesophageal perforation, carotid or vertebral artery injury, and permanent damage to nerve roots. Damage to the spinal cord might carry a risk of paraplegia. |
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