Trial reportJAMA2006
Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT) observational cohort.
Trial report in JAMA, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 267 papers, 15 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Spine Patient Outcomes Research Trial (SPORT): A Multicenter Randomized Trial for Intervertebral Disc Herniation (IDH)
Posterior Fossa Decompression With or Without Duraplasty for Chiari Type I Malformation With Syringomyelia
Randomized Controlled Trial to Determine the Best Treatment of Acetabular Fractures in Geriatric Patients: Open Reduction Internal Fixation With or Without Primary Total Hip Arthroplasty
Who cites it
267 citing papers in PubMed, 15 syntheses or guidelines pooled it.
- Use of pregabalin and limaprost in the conservative treatment of lumbar spinal stenosis: a systematic review of the current evidence.European journal of clinical pharmacology · 2026Pooled it
- Age-related spinal degenerative diseases: a quantitative analysis of the dynamic evolution, knowledge structure, and research frontiers in neurological damage.Frontiers in neurology · 2026Pooled it
- Comparative efficacy and safety of three surgical procedures for the treatment of lumbar disc herniation: a Bayesian-based network analysis.BMC surgery · 2025Pooled it
- Effect of obesity on results of endoscopic versus open lumbar discectomy: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2023Pooled it
- Extracellular Vesicles as an Emerging Treatment Option for Intervertebral Disc Degeneration: Therapeutic Potential, Translational Pathways, and Regulatory Considerations.Advanced healthcare materials · 2022Pooled it
- The Functional Role of Interface Tissue Engineering in Annulus Fibrosus Repair: Bridging Mechanisms of Hydrogel Integration with Regenerative Outcomes.ACS biomaterials science & engineering · 2020Pooled it
- The incidence of regression after the non-surgical treatment of symptomatic lumbar disc herniation: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2020Pooled it
- Total disc replacement versus fusion for lumbar degenerative diseases - a meta-analysis of randomized controlled trials.Medicine · 2019Pooled it
- Annular closure device for disc herniation: meta-analysis of clinical outcome and complications.BMC musculoskeletal disorders · 2018Pooled it
- Risk Factors for Postoperative Pain Intensity in Patients Undergoing Lumbar Disc Surgery: A Systematic Review.PloS one · 2017Pooled it
- Design Requirements for Annulus Fibrosus Repair: Review of Forces, Displacements, and Material Properties of the Intervertebral Disk and a Summary of Candidate Hydrogels for Repair.Journal of biomechanical engineering · 2016Pooled it
- Risk Factors for Recurrent Lumbar Disc Herniation: A Systematic Review and Meta-Analysis.Medicine · 2016Pooled it
- Incidence of Low Back Pain After Lumbar Discectomy for Herniated Disc and Its Effect on Patient-reported Outcomes.Clinical orthopaedics and related research · 2015Pooled it
- Outcomes of Lumbar Discectomy in Elite Athletes: The Need for High-level Evidence.Clinical orthopaedics and related research · 2015Pooled it
- The efficacy of minimally invasive discectomy compared with open discectomy: a meta-analysis of prospective randomized controlled trials.Journal of neurosurgery. Spine · 2012Pooled it
- Lumbar Microdiscectomy and Postoperative Activity Restrictions: A Randomized Controlled Trial.Spine · 2026Trial
- Comparative efficacy of ultrasound-guided erector spinae plane block versus wound infiltration for postoperative analgesia in instrumented lumbar spinal surgeries.BMC anesthesiology · 2024Trial
- CT-guided Pulsed Radiofrequency Combined with Steroid Injection for Sciatica from Herniated Disk: A Randomized Trial.Radiology · 2023Trial
- Nonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study.Scientific reports · 2021Trial
- Selective Retention of Bone Marrow Stromal Cells with Gelatin Sponge for Repair of Intervertebral Disc Defects after Microendoscopic Discectomy: A Prospective Controlled Study and 2-Year Follow-Up.BioMed research international · 2021Trial
207 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
contextFor patients with lumbar disk herniation, the Spine Patient Outcomes Research Trial (SPORT) randomized trial intent-to-treat analysis showed small but not statistically significant differences in favor of diskectomy compared with usual care. However, the large numbers of patients who crossed over between assigned groups precluded any conclusions about the comparative effectiveness of operative therapy vs usual care.
objectiveTo compare the treatment effects of diskectomy and usual care. DESIGN, SETTING, AND PATIENTS: Prospective observational cohort of surgical candidates with imaging-confirmed lumbar intervertebral disk herniation who were treated at 13 spine clinics in 11 US states and who met the SPORT eligibility criteria but declined randomization between March 2000 and March 2003.
interventionsStandard open diskectomy vs usual nonoperative care.
main outcome measuresChanges from baseline in the Medical Outcomes Study Short-Form Health Survey (SF-36) bodily pain and physical function scales and the modified Oswestry Disability Index (American Academy of Orthopaedic Surgeons/MODEMS version).
resultsOf the 743 patients enrolled in the observational cohort, 528 patients received surgery and 191 received usual nonoperative care. At 3 months, patients who chose surgery had greater improvement in the primary outcome measures of bodily pain (mean change: surgery, 40.9 vs nonoperative care, 26.0; treatment effect, 14.8; 95% confidence interval, 10.8-18.9), physical function (mean change: surgery, 40.7 vs nonoperative care, 25.3; treatment effect, 15.4; 95% CI, 11.6-19.2), and Oswestry Disability Index (mean change: surgery, -36.1 vs nonoperative care, -20.9; treatment effect, -15.2; 95% CI, -18.5. to -11.8). These differences narrowed somewhat at 2 years: bodily pain (mean change: surgery, 42.6 vs nonoperative care, 32.4; treatment effect, 10.2; 95% CI, 5.9-14.5), physical function (mean change: surgery, 43.9 vs nonoperavtive care 31.9; treatment effect, 12.0; 95% CI; 7.9-16.1), and Oswestry Disability Index (mean change: surgery -37.6 vs nonoperative care -24.2; treatment effect, -13.4; 95% CI, -17.0 to -9.7).
conclusionsPatients with persistent sciatica from lumbar disk herniation improved in both operated and usual care groups. Those who chose operative intervention reported greater improvements than patients who elected nonoperative care. However, nonrandomized comparisons of self-reported outcomes are subject to potential confounding and must be interpreted cautiously.
trial registrationclinicaltrials.gov Identifier: NCT00000410.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.