Trial reportSpine2012
Who should have surgery for an intervertebral disc herniation? Comparative effectiveness evidence from the spine patient outcomes research trial.
Trial report in Spine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Prognostic indicators of surgical outcome in painful foot drop: 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 · 2021Pooled 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
- Recurrence of Pain After Usual Nonoperative Care for Symptomatic Lumbar Disk Herniation: Analysis of Data From the Spine Patient Outcomes Research Trial.PM & R : the journal of injury, function, and rehabilitation · 2016Trial
- What Are Long-term Predictors of Outcomes for Lumbar Disc Herniation? A Randomized and Observational Study.Clinical orthopaedics and related research · 2015Trial
- Who should undergo surgery for degenerative spondylolisthesis? Treatment effect predictors in SPORT.Spine · 2013Trial
- A rare symptomatic L5-S1 anterior retroperitoneal lumbar disc herniation causing foot drop and mimicking a peripheral nerve sheath tumor: illustrative case.Journal of neurosurgery. Case lessons · 2026Article
- Review
- Prognostic factors for treatment success of conservative management and role for physiotherapy in radicular pain caused by a lumbar disc herniation: a systematic review.Brain & spine · 2025Article
- Are large language models valid tools for patient information on lumbar disc herniation? The spine surgeons' perspective.Brain & spine · 2024Article
- Back pain and radicular pain after lumbar microdiscectomy.BMC surgery · 2023Article
- International Society for the Advancement of Spine Surgery Policy 2019-Surgical Treatment of Lumbar Disc Herniation with Radiculopathy.International journal of spine surgery · 2020Article
- Article
- Predictors of clinical outcome following lumbar disc surgery: the value of historical, physical examination, and muscle function variables.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 · 2016Article
- Risk Factors for Reoperation in Patients Treated Surgically for Intervertebral Disc Herniation: A Subanalysis of Eight-Year SPORT Data.The Journal of bone and joint surgery. American volume · 2015Observational
- Which Variables Are Associated With Patient-reported Outcomes After Discectomy? Review of SPORT Disc Herniation Studies.Clinical orthopaedics and related research · 2015Review
- Negative affect and sleep disturbance may be associated with response to epidural steroid injections for spine-related pain.Archives of physical medicine and rehabilitation · 2014Article
- Article
- Role of biomechanics in intervertebral disc degeneration and regenerative therapies: what needs repairing in the disc and what are promising biomaterials for its repair?The spine journal : official journal of the North American Spine Society · 2013Review
- Surgical outcome for foot drop in lumbar degenerative disease.Global spine journal · 2012Article
- Influence of preoperative nucleus pulposus status and radiculopathy on outcomes in mono-segmental lumbar total disc replacement: results from a nationwide registry.BMC musculoskeletal disorders · 2011Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
STUDY
designCombined prospective randomized controlled trial and observational cohort study of intervertebral disc herniation (IDH), an as-treated analysis.
objectiveTo determine modifiers of the treatment effect (TE) of surgery (the difference between surgical and nonoperative outcomes) for intervertebral disc herniation (IDH) using subgroup analysis. SUMMARY OF BACKGROUND DATA: The Spine Patient Outcomes Research Trial demonstrated a positive surgical TE for IDH at the group level. However, individual characteristics may affect TE. No prior studies have evaluated TE modifiers in IDH.
methodsIDH patients underwent either discectomy (n = 788) or nonoperative care (n = 404) and were analyzed according to treatment received. Thirty-seven baseline variables were used to define subgroups for calculating the time-weighted average TE for the Oswestry Disability Index (ODI) across 4 years (TE = ΔODI(surgery) -ΔODI(nonoperative)). Variables with significant subgroup-by-treatment interactions (P < 0.1) were simultaneously entered into a multivariate model to select independent TE predictors.
resultsAll analyzed subgroups improved significantly more with surgery than with nonoperative treatment (P < 0.05). In minimally adjusted univariate analyses, being married, absence of joint problems, worsening symptom trend at baseline, high school education or less, older age, no worker's compensation, longer duration of symptoms, and an SF-36 mental component score (MCS) less than 35 were associated with greater TEs. Multivariate analysis demonstrated that being married (TE, -15.8 vs. -7.7 single, P < 0.001), absence of joint problems (TE, -14.6 vs. -10.3 joint problems, P = 0.012), and worsening symptoms (TE, -15.9 vs. -11.8 stable symptoms, P = 0.032) were independent TE modifiers. TEs were greatest in married patients with worsening symptoms (-18.3) vs. single patients with stable symptoms (-7.8).
conclusionIDH patients who met strict inclusion criteria improved more with surgery than with nonoperative treatment, regardless of specific characteristics. However, being married, without joint problems, and worsening symptom trend at baseline were associated with a greater TE.
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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.