Trial reportSpine2008
The cost effectiveness of surgical versus nonoperative treatment for lumbar disc herniation over two years: evidence from the Spine Patient Outcomes Research Trial (SPORT).
Trial report in Spine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 65 papers, 2 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)
Cost Effectiveness of Nonoperative Management for Adult Spinal Deformity Associated With Low Grade Scoliosis: A Prospective Pilot Study to Evaluate Disease Burden and Longitudinal Study Feasibility
Ozone Therapy in Patients on Waiting List for Surgery Due to Disc Herniation: Prospective, Post-authorization Study
The Effect of Mediclore as an Anti-adhesion Agent and Safety in Full-endoscopic Spine Surgery: a Preliminary Study
Who cites it
65 citing papers in PubMed, 2 syntheses or guidelines pooled 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
- Value-based care in the management of spinal disorders: a systematic review of cost-utility analysis.Clinical orthopaedics and related research · 2012Pooled it
- Feasibility, Safety, and Effectiveness of Ultrasound-Guided Acupotomy Treatment for Degenerative Lumbar Spinal Stenosis: A Pilot Randomized Controlled Trial.Journal of pain research · 2026Trial
- Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain.International journal of medical sciences · 2017Trial
- Effectiveness of surgery for lumbar stenosis and degenerative spondylolisthesis in the octogenarian population: analysis of the Spine Patient Outcomes Research Trial (SPORT) data.The Journal of bone and joint surgery. American volume · 2015Trial
- Early Patient Outcomes After Primary Total Knee Arthroplasty with Quadriceps-Sparing Subvastus and Medial Parapatellar Techniques: A Randomized, Double-Blind Clinical Trial.The Journal of bone and joint surgery. American volume · 2014Trial
- The impact of epidural steroid injections on the outcomes of patients treated for lumbar disc herniation: a subgroup analysis of the SPORT trial.The Journal of bone and joint surgery. American volume · 2012Trial
- Duration of symptoms resulting from lumbar disc herniation: effect on treatment outcomes: analysis of the Spine Patient Outcomes Research Trial (SPORT).The Journal of bone and joint surgery. American volume · 2011Trial
- Trial
- Is surgery for displaced, midshaft clavicle fractures in adults cost-effective? Results based on a multicenter randomized, controlled trial.Journal of orthopaedic trauma · 2010Trial
- Trial
- Predictors of increased length of stay and cost in readmissions for spinal surgical site infections.North American Spine Society journal · 2026Article
- Saudi Clinical Practice Guideline for the Assessment and Management of Low Back Pain and Sciatica in Adults.Journal of clinical medicine · 2026Article
- Return on Investment of the Back At Work After Surgery (BAAS) Care Pathway Compared to Care-as-Usual in Knee Arthroplasty.Journal of occupational rehabilitation · 2025Observational
- Therapeutic targeting of Nrf2/HO-1/NF-κB signaling axis with casticin mitigates intervertebral disc degeneration: in vitro and in vivo investigations.In vitro cellular & developmental biology. Animal · 2025Article
- Prevalence & Economic Burden of Adult Spinal Deformity in a Large United States Commercial Payer Population.ClinicoEconomics and outcomes research : CEOR · 2025Article
- Diabetes and heart disease do not affect short-term lumbar fusion outcomes accounting for other risk factors in a matched cohort analysis.World neurosurgery: X · 2024Article
- Intraoperative neuromonitoring in spine surgery: large database analysis of cost-effectiveness.North American Spine Society journal · 2023Article
- Cost consequence analysis of waiting for lumbar disc herniation surgery.Scientific reports · 2023Observational
- Article
5 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
STUDY
designSpine Patient Outcomes Research Trial observational and randomized cohort participants with a confirmed diagnosis of intervertebral disc herniation (IDH) who received either usual nonoperative care and/or standard open discectomy were followed from baseline at 6 weeks, 3, 6, 12, and 24 months at 13 spine clinics in 11 US states.
objectiveTo evaluate the cost-effectiveness of surgery relative to nonoperative care among patients with a confirmed diagnosis of lumbar IDH. SUMMARY OF BACKGROUND DATA: The cost-effectiveness of surgery as a treatment for conditions associated with low back and leg symptoms remains poorly understood.
methodsIncremental cost-effectiveness ratio, reported as discounted cost per quality adjusted life year (QALY) gained in 2004 US dollars based on EuroQol EQ-5D health state values with US scoring, and information on resource utilization and time away from work.
resultsAmong 775 patients who underwent surgery and 416 who were treated nonoperatively, the mean difference in QALYs over 2 years was 0.21 (95% CI: 0.16-0.25) in favor of surgery. Surgery was more costly than nonoperative care; the mean difference in total cost was $14,137(95% CI: $11,737-16,770). The cost per QALY gained for surgery relative to nonoperative care was $69,403 (95% CI: $49,523-94,999) using general adult surgery costs and $34,355 (95% CI: $20,419-52,512) using Medicare population surgery costs.
conclusionSurgery for IDH was moderately cost-effective when evaluated over 2 years. The estimated economic value of surgery varied considerably according to the method used for assigning surgical costs.
Indexed as
Identifiers
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.