Trial reportSpine2008
Surgical versus nonoperative treatment for lumbar disc herniation: four-year results for 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 trial NCT00000410 (Spine Patient Outcomes Research Trial), which is not on this map. Cited by 189 papers, 12 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)
Who cites it
189 citing papers in PubMed, 12 syntheses or guidelines pooled it.
- Objectively measured physical activity following lumbar decompression surgery: systematic review and meta-analysis.Scientific reports · 2026Pooled it
- Efficacy of oblique lumbar interbody fusion versus transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2023Pooled it
- Surgical versus non-surgical treatment for sciatica: systematic review and meta-analysis of randomised controlled trials.BMJ (Clinical research ed.) · 2023Pooled it
- Psychological predictors of quality of life and functional outcome in patients undergoing elective surgery for degenerative lumbar spine disease.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2020Pooled it
- Annular closure device for disc herniation: meta-analysis of clinical outcome and complications.BMC musculoskeletal disorders · 2018Pooled it
- Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2016Pooled 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
- Does surgical timing influence functional recovery after lumbar discectomy? A systematic review.Clinical orthopaedics and related research · 2015Pooled it
- Is sequestrectomy a viable alternative to microdiscectomy? A systematic review of the literature.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
- Herniated lumbar disc.BMJ clinical evidence · 2011Pooled it
- A new hernia blocking system to prevent recurrent lumbar disc herniation: surgical technique, intraoperative findings and six-months post-operative outcomes.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Trial
- Microdiscectomy compared with transforaminal epidural steroid injection for persistent radicular pain caused by prolapsed intervertebral disc: the NERVES RCT.Health technology assessment (Winchester, England) · 2021Trial
- Nonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study.Scientific reports · 2021Trial
- Trial
- Does reduction in sciatica symptoms precede improvement in disability and physical health among those treated surgically for intervertebral disc herniation? Analysis of temporal patterns in data from the Spine Patient Outcomes Research Trial.The spine journal : official journal of the North American Spine Society · 2018Trial
- Trial
- Lumbar microdiscectomy and post-operative activity restrictions: a protocol for a single blinded randomised controlled trial.BMC musculoskeletal disorders · 2017Trial
- Physiotherapy for Patients with Sciatica Awaiting Lumbar Micro-discectomy Surgery: A Nested, Qualitative Study of Patients' Views and Experiences.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2017Trial
129 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
designConcurrent, prospective, randomized, and observational cohort study.
objectiveTo assess the 4-year outcomes of surgery versus nonoperative care. SUMMARY OF BACKGROUND DATA: Although randomized trials have demonstrated small short-term differences in favor of surgery, long-term outcomes comparing surgical to nonoperative treatment remain controversial.
methodsSurgical candidates with imaging-confirmed lumbar intervertebral disc herniation meeting SPORT eligibility criteria enrolled into prospective, randomized (501 participants), and observational cohorts (743 participants) at 13 spine clinics in 11 US states. Interventions were standard open discectomy versus usual nonoperative care. Main outcome measures were changes from baseline in the SF-36 Bodily Pain (BP) and Physical Function (PF) scales and the modified Oswestry Disability Index (ODI - AAOS/Modems version) assessed at 6 weeks, 3 months, 6 months, and annually thereafter.
resultsNonadherence to treatment assignment caused the intent-to-treat analyses to underestimate the treatment effects. In the 4-year combined as-treated analysis, those receiving surgery demonstrated significantly greater improvement in all the primary outcome measures (mean change surgery vs. nonoperative; treatment effect; 95% CI): BP (45.6 vs. 30.7; 15.0; 11.8 to 18.1), PF (44.6 vs. 29.7; 14.9;12.0 to 17.8) and ODI (-38.1 vs. -24.9; -13.2; -15.6 to -10.9). The percent working was similar between the surgery and nonoperative groups, 84.4% versus 78.4% respectively.
conclusionIn a combined as-treated analysis at 4 years, patients who underwent surgery for a lumbar disc herniation achieved greater improvement than nonoperatively treated patients in all primary and secondary outcomes except work status.
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.