***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND CONTEXT Patients with approved workers ' compensation injuries receive guaranteed compensation for the duration of their injury , whereas patients with personal injury cl aims are only compensated , if at all , at the time of a successful settlement or trial verdict at a time point distant from their injury . PURPOSE This study compares the financial impact and loss of work patterns due to a workers ' compensation ( WC ) cl aim or personal injury in patients with a symptomatic cervical disc herniation result ing from a motor vehicle collision . STUDY DESIGN A prospect i ve study of patients who were seen by a single spine specialist between 1/2/96 and 9/1/01 . PATIENT SAMPLE A consecutive evaluation of 531 patients who were treated for a cervical pain syndrome caused by a motor vehicle collision . OUTCOME MEASURES Mechanism of injury and insurance type , ie , workers ' compensation or personal injury , was recorded for each patient as well as treatment response and return to work patterns . The data were analyzed using the two-way Z test . METHODS All patients were managed in a similar manner with noninvasive treatment initially , followed by injections , and finally surgical intervention in those who failed conservative measures . Return to work rates and work disability were determined at either final follow-up or at the last doctor 's visit before loss to follow-up . RESULTS 270 of 531 patients were diagnosed with a symptomatic one or two level disc herniation by a cervical magnetic resonance imaging scan . Fifty-four patients were insured through the workers ' compensation board , and 216 reported their crash as a personal injury cl aim . In the WC group the work disability at 3 months follow-up revealed a cumulative 2,262 total lost days of work ( average 37.1 days per person ) . At the point of maximal medical improvement ( MMI ) or 2-year follow-up , total days lost from work were 7,107 ( average 131.6 days per person . ) In the personal injury non-WC group , the 3-month follow-up of lost days of work was 1,093 days ( average 5.1 days per person . ) At 2 years follow-up , the total lost days of work were 6,206 ( average 28.7 days per person . ) CONCLUSIONS Participants compensated through the workers ' compensation system demonstrated a significant loss of days of work as compared with injured patients who received compensation by other means . This may be a reflection of the guaranteed method of compensation afforded to WC patients as opposed to patients who receive no form of financial support ( i.e. , personal injury ) during the recuperative process . Further analysis as to injury severity and a stratification of non-workers ' compensation reimbursement methods are needed to further improve the validity of this study Study Design . A prospect i ve cohort study . Objective . To assess 10-year outcomes of patients with sciatica result ing from a lumbar disc herniation treated surgically or nonsurgically . Summary of Background Data . There is little information comparing long-term outcomes of surgical and conservative therapy of lumbar disc herniation in contemporary clinical practice . Prior studies suggest that these outcomes are similar . Methods . Patients recruited from the practice s of orthopedic surgeons , neurosurgeons , and occupational medicine physicians throughout Maine had baseline interviews with follow-up question naires mailed at regular intervals over 10 years . Clinical data were obtained at baseline from a physician question naire . Primary analyses were based on initial treatment received , either surgical or nonsurgical . Secondary analyses examined actual treatments received by 10 years . Outcomes included patient-reported symptoms of leg and back pain , functional status , satisfaction , and work and disability compensation status . Results . Of 507 eligible consenting patients initially enrolled , 10-year outcomes were available for 400 of 477 ( 84 % ) surviving patients ; 217 of 255 ( 85 % ) treated surgically , and 183 of 222 ( 82 % ) treated nonsurgically . Patients undergoing surgery had worse baseline symptoms and functional status than those initially treated nonsurgically . By 10 years , 25 % of surgical patients had undergone at least one additional lumbar spine operation , and 25 % of nonsurgical patients had at least one lumbar spine operation . At 10-year follow-up , 69 % of patients initially treated surgically reported improvement in their predominant symptom ( back or leg pain ) versus 61 % of those initially treated nonsurgically ( P = 0.2 ) . A larger proportion of surgical patients reported that their low back and leg pain were much better or completely gone ( 56 % vs. 40 % , P = 0.006 ) and were more satisfied with their current status ( 71 % vs. 56 % , P = 0.002 ) . Treatment group differences persisted after adjustment for other determinants of outcome in multivariate models . Change in the modified Rol and back-specific functional status scale favored surgical treatment , and the relative benefit persisted over the follow-up period . Despite these differences , work and disability status at 10 years were comparable among those treated surgically or nonsurgically . Conclusions . Surgically treated patients with a herniated lumbar disc had more complete relief of leg pain and improved function and satisfaction compared with nonsurgically treated patients over 10 years . Nevertheless , improvement in the patient ’s predominant symptom and work and disability outcomes were similar regardless of treatment received . For patients in whom elective discectomy  is a treatment option , an individualized treatment plan requires patients and their physicians to integrate clinical findings with patient preferences based on their symptoms and goals Study Design Epidemiological review of a prospect ively collected military data base . Objective This investigation sought to determine the incidence of cervical radiculopathy and risk factors for its development within the population of the United States military from 2000 to 2009 . Summary of Background Data Currently , the epidemiology of cervical radiculopathy remains poorly understood and risk factors for its development have not been reliably defined . Methods The military 's Defense Medical Epidemiological Data base was used to identify all servicemembers diagnosed with cervical radiculopathy ( International Classification of Diseases code 723.4 ) between 2000 and 2009 .  Demographic data was obtained for all identified individuals including age group , sex , race , military rank , and branch of service . Like data was recorded for all servicemembers within the Armed Forces during the time period under study . The incidence of cervical radiculopathy was calculated and unadjusted incidence rate ratios were determined . Risk factors were analyzed by performing multivariate Poisson regression analysis , controlling for all other factors within the model . Results Between 2000 and 2009 , about 24,742 individuals were diagnosed with cervical radiculopathy among a population -at-risk of 13,813,333 , for an incidence of 1.79 per 1000 person-years . Statistically significant differences ( P<0.001 ) in adjusted incidence rate ratios were identified for each successive age group with mutually exclusive 95 % confidence intervals . Those age 40 years and above were found to have the greatest risk of cervical radiculopathy . Female sex ( P<0.001 ) , White race ( P<0.001 ) , senior positions within the rank structure ( P<0.001 ) , and service in the Army ( P<0.001 ) or Air Force ( P=0.01 ) were also identified as significant risk factors for cervical radiculopathy . Conclusions This study is the first to attempt to define the incidence of cervical radiculopathy and characterize risk factors for its development within an American population . Findings presented here indicate that age is most likely the greatest risk factor for cervical radiculopathy , with female sex , White race , senior military positions , and Army or Air Force service also influencing risk to varying degrees & NA ; The objective of this study is to determine whether depression is an independent risk factor for onset of an episode of troublesome neck and low back pain .  There is growing evidence that pain problems increase the risk of depression . However , the evidence about the role of depression as a risk factor for onset of pain problems is contradictory . This lack of consistency in research findings may be due in part to method ological weaknesses in existing studies , for example , use of an inappropriate study design and inadequate consideration of confounding . A population ‐based r and om sample of adults was surveyed and followed at 6 and 12 months . Individuals at risk of troublesome ( intense and /or disabling ) neck or low back pain are the subjects of this report ( n=790 ) . We used Cox proportional hazards models to measure the time‐varying effect of depressive symptoms on the onset of troublesome neck and low back pain . Our multivariable analysis considered the possible confounding effects of demographic and socio‐economic factors , health status , co‐morbid medical conditions and injuries to the neck or low back . We found an independent and robust relationship between depressive symptoms and onset of an episode of pain . In comparison with the lowest quartile of scores ( the least depressed ) , those in the highest quartile of depression scores had a four‐fold increased risk of troublesome neck and low back pain ( adjusted HRR 3.97 ; 95 % CI 1.81–8.72 ) . Depression is a strong and independent predictor for the onset of an episode of intense and /or disabling neck and low back pain The therapeutic modalities available for the conservative management of chronic cervical and lumbar pain include underwater traction , the usefulness of which is not universally acknowledged . No reports have been published on clinical trials evaluating underwater traction . This study was intended to ascertain any beneficial impact of weightbath therapy on the clinical parameters and quality of life of patients with cervical/lumbar discopathy . The study population comprised 72 subjects . Two groups of 18 patients each received underwater traction therapy of the cervical or lumbar spine with add-on McKenzie exercises and iontophoresis . The remaining two groups , treated with exercises and iontophoresis , served as controls . VAS and SF36 scores , range of motion were monitored to appraise therapeutic efficacy in cervical discopathy , whereas these parameters were supplemented by the Oswestry index in lumbar discopathy . A MRI scan was done at baseline and after 3 months of follow-up . Underwater cervical or lumbar traction therapy for discopathy achieved significant improvement of all study parameters , which was still evident 3 months later . Among the controls , significant improvement of just a single parameter was seen in patients with lumbar , and of two parameters in those with cervical discopathy . Underwater traction therapy effectively mitigates pain , enhances joint flexibility , and improves the quality of life of  patients with cervical or lumbar discopathy . The equipment required to administer weightbath therapy is simple to install and treatment technique is straightforward & NA ; Although neck pain is a common source of disability , little is known about its incidence and course . We conducted a population ‐based cohort study of 1100 r and omly selected Saskatchewan adults to determine the annual incidence of neck pain and describe its course . Subjects were initially surveyed by mail in September 1995 and followed‐up 6 and 12 months later . The age and gender st and ardized annual incidence of neck pain is 14.6 % ( 95 % confidence interval : 11.3 , 17.9 ) . Each year , 0.6 % ( 95 % confidence interval : 0.0–1.1 ) of the population develops disabling neck pain . The annual rate of resolution of neck pain is 36.6 % ( 95 % confidence interval : 32.7 , 40.5 ) and another 32.7 % ( 95 % confidence interval : 25.5 , 39.9 ) report improvement . Among subjects with prevalent neck pain at baseline , 37.3 % ( 95 % confidence interval : 33.4 , 41.2 ) report persistent problems and 9.9 % ( 95 % confidence interval : 7.4 , 12.5 ) experience an aggravation during follow‐up . Finally , 22.8 % ( 95 % confidence interval : 16.4 , 29.3 ) of those with prevalent neck pain at baseline report a recurrent episode . Women are more likely than men to develop neck pain ( incidence rate ratio=1.67 , 95 % confidence interval 1.08–2.60 ) ; more likely to suffer from persistent neck problems ( incidence rate ratio=1.19 , 95 % confidence interval 1.03–1.38 ) and less likely to experience resolution ( incidence rate ratio=0.75 , 95 % confidence interval 0.63–0.88 ) . Neck pain is a disabling condition with a course marked by periods of remission and exacerbation . Contrary to prior belief , most individuals with neck pain do not experience complete resolution of their symptoms and disability Study Design The Maine Lumbar Spine Study is a prospect i ve cohort study of patients recruited from the practice s of orthopedic surgeons , neurosurgeons , and occupational medicine physicians throughout Maine . Objective To assess 1‐year outcomes of patients with sciatica believed to be due to a herniated lumbar disc treated surgically or nonsurgically .  Summary of Background Data Lumbar spine surgery rates vary by geographic region and may reflect uncertainty about optimal clinical use . Methods Eligible consenting patients participated in a baseline interview performed by study personnel and then were mailed follow‐up question naires at 3 , 6 , and 12 months . Clinical data were obtained from a physician question naire . Outcomes included patient‐reported symptoms of leg and back pain , functional status , disability , quality of life , and satisfaction with care . Results Five hundred seven patients with sciatica , 275 treated surgically and 232 treated nonsurgically initially , were enrolled . Surgically treated patients , on average , had more severe symptoms and had more severe physical and imaging findings than nons 
    Output:
    
Most patients with symptomatic cervical disc herniations with radiculopathy initially present with intense pain and moderate levels of disability .
However , substantial improvements tend to occur within the first 4 to 6 months post-onset .
Patients with a workers ' compensation cl aim appeared to have a poorer prognosis .
Most patients with symptomatic cervical spine disc herniation with radiculopathy recover .