Trial reportSpine2012
Who should have surgery for spinal stenosis? Treatment effect predictors in SPORT.
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 45 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 3 syntheses or guidelines pooled it, 108 citations in OpenAlex.
- 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
- Do MRI findings identify patients with low back pain or sciatica who respond better to particular interventions? A systematic review.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
- Management of lumbar spinal stenosis.BMJ (Clinical research ed.) · 2016Pooled it
- Surgery versus nonsurgical treatment of lumbar spinal stenosis: a randomized trial.Annals of internal medicine · 2015Trial
- Minimally invasive decompression versus open laminectomy for central stenosis of the lumbar spine: pragmatic comparative effectiveness study.BMJ (Clinical research ed.) · 2015Trial
- Who should undergo surgery for degenerative spondylolisthesis? Treatment effect predictors in SPORT.Spine · 2013Trial
- Saudi Clinical Practice Guideline for the Assessment and Management of Low Back Pain and Sciatica in Adults.Journal of clinical medicine · 2026Article
- Pain, quality of life, and function in chronic intractable leg pain were substantially improved with 10kHz spinal cord stimulation in a multicentre European study.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 · 2025Observational
- 24-month patient-reported outcomes for a novel lumbar total joint replacement.North American Spine Society journal · 2025Article
- A comparative analysis between ChatGPT versus NASS clinical guidelines for adult isthmic spondylolisthesis.North American Spine Society journal · 2025Article
- Comparison of Endoscopic Unilateral Laminectomy for Bilateral Decompression (Endo-ULBD) and Posterior Lumbar Interbody Fusion (PLIF) in Managing Multi-Segmental Lumbar Spinal Stenosis: Technique and Early Outcomes.Orthopaedic surgery · 2025Article
- Long-term reoperation risk of thoracic to pelvis instrumentation for spinal deformity: a longitudinal study of 7,062 patients.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
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- Poor muscle health and low preoperative ODI are independent predictors for slower achievement of MCID after minimally invasive decompression.The spine journal : official journal of the North American Spine Society · 2023Article
- Frequency and determinants of surgical treatment in patients with uncomplicated disc-related sciatica hospitalized in the Rheumatology Department of Lille University Hospital.Journal of spine surgery (Hong Kong) · 2022Article
- Smoking cessation intervention prior to orthopedic surgery: A study protocol to determine patient outcomes and feasibility.Tobacco prevention & cessation · 2022Article
- Prediction of walking ability following posterior decompression for lumbar spinal 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 · 2021Observational
- Surgery for Lumbar Spinal Stenosis in Patients With Mild Leg Pain Levels Is Associated With Unsatisfactory Outcome.Global spine journal · 2021Article
- Classification and prognostic factors of residual symptoms after minimally invasive lumbar decompression surgery using a cluster analysis: a 5-year follow-up cohort study.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 · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
STUDY
designCombined prospective randomized controlled trial and observational cohort study of spinal stenosis (SpS) with an as-treated analysis.
objectiveTo determine modifiers of the treatment effect (TE) of surgery (the difference between surgical and nonoperative outcomes) for SpS using subgroup analysis. SUMMARY OF BACKGROUND DATA: The Spine Patient Outcomes Research Trial demonstrated a positive surgical TE for SpS at the group level. However, individual characteristics may affect TE. No previous studies have evaluated TE modifiers in SpS.
methodsSpS patients were treated with either surgery (n = 419) or nonoperative care (n = 235) and were analyzed according to treatment received. Fifty-three baseline variables were used to define subgroups for calculating the time-weighted average TE for the Oswestry Disability Index (ODI) over 4 years (TE = ΔODIsurgery - ΔODInonoperative). Variables with significant subgroup × treatment interactions (P < 0.05) were simultaneously entered into a multivariate model to select independent TE predictors.
resultsOther than smokers, all analyzed subgroups including at least 50 patients improved significantly more with surgery than with nonoperative treatment (P < 0.05). Multivariate analysis demonstrated: baseline ODI ≤ 56 (TE -15.0 vs. -4.4, ODI > 56, P < 0.001), not smoking (TE -11.7 vs. -1.6 smokers, P < 0.001), neuroforaminal stenosis (TE -14.2 vs. -8.7 no neuroforaminal stenosis, P = 0.002), predominant leg pain (TE -11.5 vs. -7.3 predominant back pain, P = 0.035), not lifting at work (TE -12.5 vs. -0.5 lifting at work, P = 0.017), and the presence of a neurological deficit (TE -13.3 vs. -7.2 no neurological deficit, P < 0.001) were associated with greater TE.
conclusionWith the exception of smokers, patients who met strict inclusion criteria improved more with surgery than with nonoperative treatment, regardless of other specific characteristics. However, TE varied significantly across certain subgroups, and these data can be used to individualize shared decision making discussions about likely outcomes. Smoking cessation should be considered before surgery for SpS.
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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.