ArticleSpine2011
Comparative effectiveness evidence from the spine patient outcomes research trial: surgical versus nonoperative care for spinal stenosis, degenerative spondylolisthesis, and intervertebral disc herniation.
Article in Spine, 2011. 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 77 papers, 9 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 Degenerative Spondylolisthesis (DS) With Spinal Stenosis (SpS) at L4/L5 Level.
Spine Patient Outcomes Research Trial (SPORT): A Multicenter Randomized Trial for Intervertebral Disc Herniation (IDH)
Spine Patient Outcomes Research Trial (SPORT): A Multicenter Trial for Spinal Stenosis (SpS)
Who cites it
77 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- Surgical versus non-surgical treatment for sciatica: systematic review and meta-analysis of randomised controlled trials.BMJ (Clinical research ed.) · 2023Pooled it
- Methodology of economic evaluations in spine surgery: a systematic review and qualitative assessment.BMJ open · 2023Pooled it
- Pain and disability after first-time spinal fusion for lumbar degenerative disorders: 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 · 2019Pooled it
- A systematic literature review of time to return to work and narcotic use after lumbar spinal fusion using minimal invasive and open surgery techniques.BMC health services research · 2017Pooled it
- Degenerative spondylolisthesis: contemporary review of the role of interbody fusion.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2017Pooled 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
- Surgical versus non-surgical treatment for lumbar spinal stenosis.The Cochrane database of systematic reviews · 2016Pooled it
- MIS lateral spine surgery: a systematic literature review of complications, outcomes, and economics.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 · 2015Pooled 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
- 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
- Surgical technique and effectiveness of microendoscopic discectomy for large uncontained lumbar disc herniations: a prospective, randomized, controlled study with 8 years of follow-up.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 · 2014Trial
- Fluoroscopic caudal epidural injections in managing post lumbar surgery syndrome: two-year results of a randomized, double-blind, active-control trial.International journal of medical sciences · 2012Trial
- Radiographic and clinical outcomes at 12 months following full endoscopic interlaminar decompression for grade 1 degenerative lumbar spondylolisthesis.Scientific reports · 2025Article
- Mapping the field of spondylolisthesis: A bibliometric analysis.World journal of clinical cases · 2025Article
- How Painful are Lumbar Hernias? A Comprehensive Review of Intervention Strategies.Current pain and headache reports · 2025Review
- Long-Term Prognosis of Surgical and Non-Surgical Treatment for Lumbar Spinal Stenosis: A Retrospective Cohort Study.Journal of pain research · 2025Article
- Comparing opioid utilization and costs for surgical management of single-level spondylolisthesis: A national claims database analysis.Journal of orthopaedics · 2024Article
- Plant-Derived Senotherapeutics for the Prevention and Treatment of Intervertebral Disc Degeneration and Aging.Metabolites · 2024Review
- Cost-effectiveness of a second opinion program on spine surgeries: an economic analysis.BMC health services research · 2023Article
- Combining adhesive and nonadhesive injectable hydrogels for intervertebral disc repair in an ovine discectomy model.JOR spine · 2023Article
17 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
12 authors.
Funding
Abstract
STUDY
designCost-effectiveness analysis of a randomized plus observational cohort trial.
objectiveAnalyze cost-effectiveness of Spine Patient Outcomes Research Trial data over 4 years comparing surgery with nonoperative care for three common diagnoses: spinal stenosis (SPS), degenerative spondylolisthesis (DS), and intervertebral disc herniation (IDH). SUMMARY OF BACKGROUND DATA: Spine surgery rates continue to rise in the United States, but the safety and economic value of these procedures remain uncertain.
methodsPatients with image-confirmed diagnoses were followed in randomized or observational cohorts with data on resource use, productivity, and EuroQol EQ-5D health state values measured at 6 weeks, 3, 6, 12, 24, 36, and 48 months. For each diagnosis, cost per quality-adjusted life year (QALY) gained in 2004 US dollars was estimated for surgery relative to nonoperative care using a societal perspective, with costs and QALYs discounted at 3% per year.
resultsSurgery was performed initially or during the 4-year follow-up among 414 of 634 (65.3%) SPS, 391 of 601 (65.1%) DS, and 789 of 1192 (66.2%) IDH patients. Surgery improved health, with persistent QALY differences observed through 4 years (SPS QALY gain 0.22; 95% confidence interval, CI: 0.15, 0.34; DS QALY gain 0.34, 95% CI: 0.30, 0.47; and IDH QALY gain 0.34, 95% CI: 0.31, 0.38). Costs per QALY gained decreased for SPS from $77,600 at 2 years to $59,400 (95% CI: $37,059, $125,162) at 4 years, for DS from $115,600 to $64,300 per QALY (95% CI: $32,864, $83,117), and for IDH from $34,355 to $20,600 per QALY (95% CI: $4,539, $33,088).
conclusionComparative effectiveness evidence for clearly defined diagnostic groups from Spine Patient Outcomes Research Trial shows good value for surgery compared with nonoperative care over 4 years.
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.