ArticleAnnals of internal medicine2008
Surgical treatment of spinal stenosis with and without degenerative spondylolisthesis: cost-effectiveness after 2 years.
Article in Annals of internal medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 80 papers, 3 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 Trial for Spinal Stenosis (SpS)
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
Who cites it
80 citing papers in PubMed, 3 syntheses or guidelines pooled it, 265 citations in OpenAlex.
- Decompression alone or fusion in single-level lumbar spinal stenosis with spondylolisthesis? A systematic review and meta analysis.BMC musculoskeletal disorders · 2024Pooled it
- Epidural injections with or without steroids in managing chronic low back pain secondary to lumbar spinal stenosis: a meta-analysis of 13 randomized controlled trials.Drug design, development and therapy · 2015Pooled it
- Value-based care in the management of spinal disorders: a systematic review of cost-utility analysis.Clinical orthopaedics and related research · 2012Pooled it
- Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain.International journal of medical sciences · 2017Trial
- A protocol of a randomized controlled multicenter trial for surgical treatment of lumbar spondylolisthesis: the Lumbar Interbody Fusion Trial (LIFT).BMC musculoskeletal disorders · 2016Trial
- A prospective randomized comparative study of postoperative pain control using an epidural catheter in patients undergoing posterior lumbar interbody fusion.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 · 2016Trial
- Assessment of effectiveness of percutaneous adhesiolysis in managing chronic low back pain secondary to lumbar central spinal canal stenosis.International journal of medical sciences · 2013Trial
- 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
- Is surgery for displaced, midshaft clavicle fractures in adults cost-effective? Results based on a multicenter randomized, controlled trial.Journal of orthopaedic trauma · 2010Trial
- Should venous thromboembolism chemoprophylaxis be utilized following spinal fusions?-a systematic review and literature-based decision analysis.Journal of spine surgery (Hong Kong) · 2026Review
- Cost-Effectiveness of Minimally Invasive Tubular vs. Open Laminectomy for Pure Lumbar Spinal Stenosis: A Markov State-Transition Analysis.Global spine journal · 2026Article
- Cost-Effectiveness of 3D-Printed Patient-Specific Versus Off-the-Shelf Interbody Cages in Lumbar Spinal Fusion: A Markov Model Cost-Utility Analysis.Journal of market access & health policy · 2026Article
- Saudi Clinical Practice Guideline for the Assessment and Management of Low Back Pain and Sciatica in Adults.Journal of clinical medicine · 2026Article
- Socioeconomic Implications of Recurrent Lumbar Disc Herniation: A Narrative Review.Neurospine · 2026Review
- Mapping the field of spondylolisthesis: A bibliometric analysis.World journal of clinical cases · 2025Article
- No drugs, more sex? And Rock'n Roll: effective non-operative treatments and practical management strategies for older adults with lumbar spinal stenosis.Chiropractic & manual therapies · 2025Review
- Disc bulging predicts poor outcomes of decompression surgery for lumbar spinal canal stenosis.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 · 2025Article
- Time to achievement of minimum clinically important difference after lumbar decompression.Acta neurochirurgica · 2023Article
- Personalized Interventional Surgery of the Lumbar Spine: A Perspective on Minimally Invasive and Neuroendoscopic Decompression for Spinal Stenosis.Journal of personalized medicine · 2023Article
- Is Indirect Decompression and Fusion More Effective than Direct Decompression and Fusion for Treating Degenerative Lumbar Spinal Stenosis With Instability? A Systematic Review and meta-Analysis.Global spine journal · 2023Review
20 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
14 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundThe SPORT (Spine Patient Outcomes Research Trial) reported favorable surgery outcomes over 2 years among patients with stenosis with and without degenerative spondylolisthesis, but the economic value of these surgeries is uncertain.
objectiveTo assess the short-term cost-effectiveness of spine surgery relative to nonoperative care for stenosis alone and for stenosis with spondylolisthesis.
designProspective cohort study. DATA SOURCES: Resource utilization, productivity, and EuroQol EQ-5D score measured at 6 weeks and at 3, 6, 12, and 24 months after treatment among SPORT participants. TARGET POPULATION: Patients with image-confirmed spinal stenosis, with and without degenerative spondylolisthesis. TIME HORIZON: 2 years. PERSPECTIVE: Societal.
interventionNonoperative care or surgery (primarily decompressive laminectomy for stenosis and decompressive laminectomy with fusion for stenosis associated with degenerative spondylolisthesis). OUTCOME MEASURES: Cost per quality-adjusted life-year (QALY) gained. RESULTS OF BASE-CASE ANALYSIS: Among 634 patients with stenosis, 394 (62%) had surgery, most often decompressive laminectomy (320 of 394 [81%]). Stenosis surgeries improved health to a greater extent than nonoperative care (QALY gain, 0.17 [95% CI, 0.12 to 0.22]) at a cost of $77,600 (CI, $49,600 to $120,000) per QALY gained. Among 601 patients with degenerative spondylolisthesis, 368 (61%) had surgery, most including fusion (344 of 368 [93%]) and most with instrumentation (269 of 344 [78%]). Degenerative spondylolisthesis surgeries significantly improved health versus nonoperative care (QALY gain, 0.23 [CI, 0.19 to 0.27]), at a cost of $115,600 (CI, $90,800 to $144,900) per QALY gained. RESULT OF SENSITIVITY ANALYSIS: Surgery cost markedly affected the value of surgery. LIMITATION: The study used self-reported utilization data, 2-year time horizon, and as-treated analysis to address treatment nonadherence among randomly assigned participants.
conclusionThe economic value of spinal stenosis surgery at 2 years compares favorably with many health interventions. Degenerative spondylolisthesis surgery is not highly cost-effective over 2 years but could show value over a longer time horizon.
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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.