Trial reportSpine2014
Surgical versus nonoperative treatment for lumbar disc herniation: eight-year results for the spine patient outcomes research trial.
Trial report in Spine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT05711706 (The Effect of Su Jok Application on Pain, Anxiety and Quality of Recovery After Lumbar Disc Surgery), which is not on this map. Cited by 137 papers, 6 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.
The Effect of Su Jok Application on Pain, Anxiety and Quality of Recovery After Lumbar Disc Surgery
Who cites it
137 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Comparison of different treatments for lumbar disc herniation: a network meta-analysis and systematic review.BMC surgery · 2025Pooled it
- Surgical versus non-surgical treatment for sciatica: systematic review and meta-analysis of randomised controlled trials.BMJ (Clinical research ed.) · 2023Pooled it
- Evaluating the Impact of Modic Changes on Operative Treatment in the Cervical and Lumbar Spine: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2022Pooled it
- Balancing biological and biomechanical performance in intervertebral disc repair: a systematic review of injectable cell delivery biomaterials.European cells & materials · 2020Pooled it
- Annular closure device for disc herniation: meta-analysis of clinical outcome and complications.BMC musculoskeletal disorders · 2018Pooled it
- Non-steroidal anti-inflammatory drugs for sciatica.The Cochrane database of systematic reviews · 2016Pooled it
- Nonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study.Scientific reports · 2021Trial
- 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
- Does early intervention improve outcomes in physiotherapy management of lumbar radicular syndrome? A mixed-methods study protocol.BMJ open · 2017Trial
- The effect of short (2-weeks) versus long (6-weeks) post-operative restrictions following lumbar discectomy: a prospective randomized control trial.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 · 2017Trial
- Predictors and Outcomes of Crossover to Surgery from Physical Therapy for Meniscal Tear and Osteoarthritis: A Randomized Trial Comparing Physical Therapy and Surgery.The Journal of bone and joint surgery. American volume · 2016Trial
- Surgical Outcome Predictor in Degenerative Lumbar Spinal Disease Based on Health Related Quality of Life Using Euro-Quality 5 Dimensions Analysis.Yonsei medical journal · 2016Trial
- 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
- Trial
- What Are Long-term Predictors of Outcomes for Lumbar Disc Herniation? A Randomized and Observational Study.Clinical orthopaedics and related research · 2015Trial
- A pragmatic evaluation of outcome fragility in randomized clinical trials comparing open microdiscectomy and endoscopic-assisted discectomy: A meta-analysis.North American Spine Society journal · 2026Review
- Lumbar disc herniation with giant extruded or sequestered morphology: feasibility of a conservative-first strategy and the stratification value of contrast-enhanced MRI.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 · 2026Article
- Is pain relief enough? Early response discordance after lumbar decompressive surgery: a prospective cohort study.BMC musculoskeletal disorders · 2026Observational
- Enhancing Precision in Lumbar Spine Surgery Through Spinal Endoscopy: A Narrative Review with Expert Opinion.Journal of personalized medicine · 2026Review
77 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on byTO THE EDITOR.2017
- Commented on byTO THE EDITOR.2017
- Erratum issued
Authors and funding
8 authors.
Funding
Abstract
STUDY
designConcurrent prospective randomized and observational cohort studies.
objectiveTo assess the 8-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 with nonoperative treatment remain controversial.
methodsSurgical candidates with imaging-confirmed lumbar intervertebral disc herniation meeting Spine Patient Outcomes Research Trial 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 and Physical Function scales and the modified Oswestry Disability Index-AAOS/Modems version assessed at 6 weeks, 3 months, and 6 months, and annually thereafter.
resultsAdvantages were seen for surgery in intent-to-treat analyses for the randomized cohort for all primary and secondary outcomes other than work status; however, with extensive nonadherence to treatment assignment (49% patients assigned to nonoperative therapy receiving surgery versus 60% of patients assigned to surgery) these observed effects were relatively small and not statistically significant for primary outcomes (bodily pain, physical function, Oswestry Disability Index). Importantly, the overall comparison of secondary outcomes was significantly greater with surgery in the intent-to-treat analysis (sciatica bothersomeness [P > 0.005], satisfaction with symptoms [P > 0.013], and self-rated improvement [P > 0.013]) in long-term follow-up. An as-treated analysis showed significant surgical treatment effects for primary outcome measures (mean change, surgery vs. nonoperative care; treatment effect; 95% confidence interval): bodily pain (45.3 vs. 34.4; 10.9; 7.7 to 14); PF (42.2 vs. 31.5; 10.6; 7.7 to 13.5); and Oswestry Disability Index (-36.2 vs. -24.8; -11.3; -13.6 to -9.1).
conclusionCarefully selected patients who underwent surgery for a lumbar disc herniation achieved greater improvement than nonoperatively treated patients; there was little to no degradation of outcomes in either group (operative and nonoperative) from 4 to 8 years. LEVEL OF EVIDENCE: 2.
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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.