March 2012 JAAOS News Highlights
Spine Patient Outcomes Research Trial (SPORT) Provides Lessons in Treatment and Care
The Spine Patient Outcomes Research Trial (SPORT) is the first comprehensive study to look at the effectiveness of different treatments for low back and leg pain. It was designed to provide data and outcomes to guide doctors and their patients in their treatment choices for three common spinal disorders: intervertebral disk herniation (IDH), degenerative spondylolisthesis (DS), and lumbar spinal stenosis (LSS). The results from the trial, which began in 2000, are already having a strong impact on orthopaedic practice, and the appropriate role of surgical intervention, according to a review on SPORT appearing in the March issue of the JAAOS. Treatment of spinal disorders, both surgical and nonsurgical, comes at a high cost to insurance providers, hospitals and society. However, the assessment of patient-generated outcomes has produced cost-effectiveness data supporting surgical treatment for these conditions, as they provide significant value to the patient over the long term. Most patients, according to the trial results, knew where their condition was headed. Those who noted improvement, or who felt that their symptoms were tolerable, recognized the value of waiting further, while those who felt no significant relief knew they needed surgical care. All primary outcomes "significantly favored surgical treatment "for IDH, DS and LSS. However, both surgical and non-surgical treatment for IDH resulted in significant relief of low back and leg pain. Surgery was much more effective over non-surgical treatments in treating DS and LSS symptoms.