AANEM News Express

AANEM News Express

SPORT and Spine: Long-term Outcomes of Lumbar Spinal Stenosis

Lurie J, Tosteson T, Tosteson A, et al.  Spine. 15 January 2015; 40(2): 63–76.
SPORT is a very large randomized trial with a concurrent observational cohort study that involved 13 spine centers in 11 US states. Part of the study compared the outcomes of surgery (decompressive laminectomy) with non-operative care for symptomatic lumbar spinal stenosis. Primary outcomes were SF-36 Bodily Pain and Physical Function scales and the modified Oswestry Disability Index. This study followed the results of SPORT out to 8 years as prior data showed surgery for spinal stenosis was more effective than non-operative treatment during 4 years. At 8-year follow up, intent-to-treat analyses showed no differences between randomized cohorts. As-treated analyses in the randomized group showed that the early benefit for surgery out to 4 years converged over time, with no significant treatment effect of surgery seen in years 6 to 8 for any of the primary outcomes. In contrast, the observational group showed a stable advantage for surgery in all outcomes between years 5 and 8.
Comment: SPORT is the largest study of its kind to compare surgical vs non-surgical treatment of spine disorders. This study is one of the papers coming out of SPORT that followed the long term outcome to 8 years in patients with lumbar spinal stenosis. The study showed diminishing benefits of surgery in as-treated analyses of the randomized group between 4 and 8 years, whereas outcomes in the observational group remained stable. It is difficult to translate the result of this study towards a significant clinical change. However, it does point out the possibility that surgical treatment for lumbar spinal stenosis may not have the long-term benefit past 4 years.

Icon Credit: The Present Group

View Related News Stories:

  PracticeSpinePainLumbar Stenosis

Recent AANEM News

Resources for Small Practices During COVID-19

Science News: Imaging of the Peripheral Nerve: Concepts and Future Direction of Magnetic Resonance Neurography and Ultrasound

Science News: Treadmill Training in Patients Affected by Charcot-Marie-Tooth Neuropathy: Results of a Multicenter, Prospective, Randomized, Single-blind, Controlled Study

Registration for ABEM's 2020 Neuromuscular Ultrasound Certificate of Added Qualification (CAQ) Exam is Open

Science News: Combined Intravenous Immunoglobulin and Methylprednisolone as Induction Treatment in Chronic Inflammatory Demyelinating Polyneuropathy (OPTIC protocol): A Prospective Pilot Study






Devon products