Table 1 Selection criteria for trial eligibility

Inclusion criteria

• Age 18-75 years

• Radicular signs and symptoms in one or both arms (i.e., pain, paresthesia or paresis in a specific nerve root distribution) or symptoms and signs of acute or chronic myelopathy

• At least 8 weeks prior conservative treatment (i.e., physical therapy, pain medication)

• Radiographic diagnosis of cervical disc herniation and/or osteophyte at 1 level (C3-C4 to C7-T1) in accordance with clinical signs and symptoms

• Ability and willingness to comply with project requirements

• Written informed consent given by the subject or the subject's legally authorised representative

Exclusion criteria

• Previous cervical surgery (either anterior or posterior)

• Increased motion on dynamic studies (> 3 mm)

• Severe segmental kyphosis of the involved disc level (> 7 degrees)

• Patient cannot be imaged with MRI

• Neck pain only (without radicular or medullary symptoms)

• Infection

• Metabolic and bone diseases (osteoporosis, severe osteopenia)

• Neoplasm or trauma of the cervical spine

• Spinal anomaly (Klippel Feil, Bechterew, OPLL)

• Severe mental or psychiatric disorder

• Inadequate Dutch language

• Planned (e)migration abroad in the year after inclusion