Evidence-based approach to lumbar disc herniation: Findings from the SPORT trial (primary and subgroup analyses)
Abstract The SPORT disc herniation study was the largest study ever performed comparing surgical and nonoperative outcomes for lumbar disc herniation. The study demonstrated that patients improved significantly with both surgery and nonoperative treatment; however, patients treated surgically improv...
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Published in | Seminars in spine surgery Vol. 28; no. 1; pp. 26 - 30 |
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01.03.2016
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Abstract | Abstract The SPORT disc herniation study was the largest study ever performed comparing surgical and nonoperative outcomes for lumbar disc herniation. The study demonstrated that patients improved significantly with both surgery and nonoperative treatment; however, patients treated surgically improved faster and to a greater degree. These results were maintained through 8 years of follow-up. Subgroup analyses demonstrated that many patients and disease characteristics were associated with both surgical and nonoperative outcomes; however, very few predicted surgical treatment effect. All examined subgroups improved more with surgery than nonoperative treatment over 4 years of follow-up. Complications were relatively rare and tended not to affect long-term outcomes. |
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AbstractList | Abstract The SPORT disc herniation study was the largest study ever performed comparing surgical and nonoperative outcomes for lumbar disc herniation. The study demonstrated that patients improved significantly with both surgery and nonoperative treatment; however, patients treated surgically improved faster and to a greater degree. These results were maintained through 8 years of follow-up. Subgroup analyses demonstrated that many patients and disease characteristics were associated with both surgical and nonoperative outcomes; however, very few predicted surgical treatment effect. All examined subgroups improved more with surgery than nonoperative treatment over 4 years of follow-up. Complications were relatively rare and tended not to affect long-term outcomes. The SPORT disc herniation study was the largest study ever performed comparing surgical and nonoperative outcomes for lumbar disc herniation. The study demonstrated that patients improved significantly with both surgery and nonoperative treatment; however, patients treated surgically improved faster and to a greater degree. These results were maintained through 8 years of follow-up. Subgroup analyses demonstrated that many patients and disease characteristics were associated with both surgical and nonoperative outcomes; however, very few predicted surgical treatment effect. All examined subgroups improved more with surgery than nonoperative treatment over 4 years of follow-up. Complications were relatively rare and tended not to affect long-term outcomes. |
Author | Pearson, Adam, MD, MS Klare, Christian, MD McEntarfer, Ross A., MD, MS |
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Cites_doi | 10.1001/jama.296.20.2441 10.1097/BRS.0000000000000088 10.1097/BRS.0b013e31820bfb9a 10.1097/BRS.0b013e3181c68047 10.1001/jama.296.20.2451 10.2106/JBJS.G.00913 10.3171/2011.1.SPINE10426 10.1308/003588410X12518836438840 10.1097/00007632-198303000-00003 10.1097/BRS.0b013e31818ed8f4 10.1097/BRS.0b013e31816469de 10.1097/BRS.0b013e3182276b2b 10.1097/01.brs.0000229252.30903.b9 10.1097/01.brs.0000158954.68522.2a 10.2106/JBJS.K.01558 |
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References | Atlas, Keller, Wu, Deyo, Singer (bib4) 2005; 30 Benson, Tavares, Robertson, Sharp, Marshall (bib6) 2010; 92 Lurie, Faucett, Hanscom (bib12) 2008; 90 Olson, Lurie, Frymoyer (bib10) 2011; 36 Weinstein, Bronner, Morgan, Wennberg (bib3) 2004 Weinstein, Lurie, Tosteson (bib1) 2006; 296 Slover, Abdu, Hanscom, Weinstein (bib9) 2006; 31 Pearson, Lurie, Tosteson (bib15) 2012; 37 Weinstein, Tosteson, Lurie (bib2) 2006; 296 Rihn, Kurd, Hilibrand (bib14) 2013; 95 Desai, Ball, Bekelis (bib16) 2011; 14 Weber (bib5) 1983; 8 Weinstein, Lurie, Tosteson (bib7) 2008; 33 Lurie, Tosteson, Tosteson (bib8) 2014; 39 Pearson, Blood, Frymoyer (bib11) 2008; 33 Atlas, Tosteson, Blood, Skinner, Pransky, Weinstein (bib13) 2010; 35 Weinstein (10.1053/j.semss.2015.08.007_bib1) 2006; 296 Slover (10.1053/j.semss.2015.08.007_bib9) 2006; 31 Atlas (10.1053/j.semss.2015.08.007_bib13) 2010; 35 Weinstein (10.1053/j.semss.2015.08.007_bib3) 2004 Pearson (10.1053/j.semss.2015.08.007_bib15) 2012; 37 Weinstein (10.1053/j.semss.2015.08.007_bib7) 2008; 33 Desai (10.1053/j.semss.2015.08.007_bib16) 2011; 14 Weinstein (10.1053/j.semss.2015.08.007_bib2) 2006; 296 Benson (10.1053/j.semss.2015.08.007_bib6) 2010; 92 Lurie (10.1053/j.semss.2015.08.007_bib8) 2014; 39 Weber (10.1053/j.semss.2015.08.007_bib5) 1983; 8 Lurie (10.1053/j.semss.2015.08.007_bib12) 2008; 90 Rihn (10.1053/j.semss.2015.08.007_bib14) 2013; 95 Atlas (10.1053/j.semss.2015.08.007_bib4) 2005; 30 Olson (10.1053/j.semss.2015.08.007_bib10) 2011; 36 Pearson (10.1053/j.semss.2015.08.007_bib11) 2008; 33 |
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A controlled, prospective study with ten years of observation publication-title: Spine doi: 10.1097/00007632-198303000-00003 contributor: fullname: Weber – volume: 33 start-page: 2789 issue: 25 year: 2008 ident: 10.1053/j.semss.2015.08.007_bib7 article-title: Surgical versus nonoperative treatment for lumbar disc herniation: four-year results for the Spine Patient Outcomes Research Trial (SPORT) publication-title: Spine doi: 10.1097/BRS.0b013e31818ed8f4 contributor: fullname: Weinstein – volume: 33 start-page: 428 issue: 4 year: 2008 ident: 10.1053/j.semss.2015.08.007_bib11 article-title: SPORT lumbar intervertebral disk herniation and back pain: does treatment, location, or morphology matter? publication-title: Spine doi: 10.1097/BRS.0b013e31816469de contributor: fullname: Pearson – volume: 37 start-page: 140 issue: 4 year: 2012 ident: 10.1053/j.semss.2015.08.007_bib15 article-title: Who should have surgery for an intervertebral disc herniation? Comparative effectiveness evidence from the spine patient outcomes research trial publication-title: Spine doi: 10.1097/BRS.0b013e3182276b2b contributor: fullname: Pearson – volume: 31 start-page: 1974 issue: 17 year: 2006 ident: 10.1053/j.semss.2015.08.007_bib9 article-title: The impact of comorbidities on the change in short-form 36 and oswestry scores following lumbar spine surgery publication-title: Spine (Phila Pa 1976) doi: 10.1097/01.brs.0000229252.30903.b9 contributor: fullname: Slover – volume: 30 start-page: 927 issue: 1 year: 2005 ident: 10.1053/j.semss.2015.08.007_bib4 article-title: Long-term outcomes of surgical and nonsurgical management of sciatica secondary to a lumbar disc herniation: 10 year results from the maine lumbar spine study publication-title: Spine doi: 10.1097/01.brs.0000158954.68522.2a contributor: fullname: Atlas – volume: 95 start-page: 1 issue: 20 year: 2013 ident: 10.1053/j.semss.2015.08.007_bib14 article-title: The influence of obesity on the outcome of treatment of lumbar disc herniation: analysis of the Spine Patient Outcomes Research Trial (SPORT) publication-title: J Bone Joint Surg Am doi: 10.2106/JBJS.K.01558 contributor: fullname: Rihn |
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Snippet | Abstract The SPORT disc herniation study was the largest study ever performed comparing surgical and nonoperative outcomes for lumbar disc herniation. The... The SPORT disc herniation study was the largest study ever performed comparing surgical and nonoperative outcomes for lumbar disc herniation. The study... |
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Title | Evidence-based approach to lumbar disc herniation: Findings from the SPORT trial (primary and subgroup analyses) |
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