TY - JOUR
T1 - Systematic Review of Outcomes following 10-year Mark of Spine Patient Outcomes Research Trial (SPORT) for Spinal Stenosis
AU - Oster, Brittany A.
AU - Kikanloo, Sina Rashidi
AU - Levine, Nicole L.
AU - Lian, Jayson
AU - Cho, Woojin
N1 - Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/6/15
Y1 - 2020/6/15
N2 - Study Design.We performed a comprehensive search of Pubmed, MEDLINE, and EMBASE for all English-language studies of all levels of evidence pertaining to SPORT, in accordance with Preferred Reported Items for Systematic Reviews and Meta-analayses (PRISMA) guidelines.Objective.We aim to summarize the 10-year clinical outcomes of SPORT and its numerous follow-up studies for spinal stenosis.Summary of Background Data.The Spine Patient Outcomes Research Trial (SPORT) was a landmark randomized control trial including approximately 2,500 patients at 13 clinics across the country. SPORT compared surgical and nonoperative management of the three most common spinal pathologies.Methods.Keywords utilized in the literature search included: SPORT, spine patient outcomes research trial, spinal stenosis, and surgical outcomes.Results.Surgical intervention showed significantly greater improvement in pain and physical function scales from 6 weeks through 4 years. However, between 4 and 8 years, the difference between the two groups diminished, and the benefits in both groups stabilized. Secondary factors investigated showed that smoking was a confounding variable for treatment benefits and a positive sedimentation sign correlated with a greater surgical treatment effect. Obese patients were found to have higher rates of infection and reoperation and less improvement from baseline function. Risk factors for reoperation included duration of pretreatment symptoms for longer than 12 months, increased age, multiple levels of stenosis, predominant back pain, no physical therapy, greater leg pain, the use of antidepressants and no neurogenic claudication upon enrollment.Conclusion.Ten years after its inception, SPORT has made strides in standardization and optimization of treatment for spinal pathologies. SPORT has provided clinicians with insight about outcomes of surgical and nonoperative treatment of spinal stenosis. Results showed significantly greater improvement through 4 year follow up in those patients that received surgical treatment, however the difference between the surgical and nonsurgical groups diminished at 8 year follow up.Level of Evidence: 3.
AB - Study Design.We performed a comprehensive search of Pubmed, MEDLINE, and EMBASE for all English-language studies of all levels of evidence pertaining to SPORT, in accordance with Preferred Reported Items for Systematic Reviews and Meta-analayses (PRISMA) guidelines.Objective.We aim to summarize the 10-year clinical outcomes of SPORT and its numerous follow-up studies for spinal stenosis.Summary of Background Data.The Spine Patient Outcomes Research Trial (SPORT) was a landmark randomized control trial including approximately 2,500 patients at 13 clinics across the country. SPORT compared surgical and nonoperative management of the three most common spinal pathologies.Methods.Keywords utilized in the literature search included: SPORT, spine patient outcomes research trial, spinal stenosis, and surgical outcomes.Results.Surgical intervention showed significantly greater improvement in pain and physical function scales from 6 weeks through 4 years. However, between 4 and 8 years, the difference between the two groups diminished, and the benefits in both groups stabilized. Secondary factors investigated showed that smoking was a confounding variable for treatment benefits and a positive sedimentation sign correlated with a greater surgical treatment effect. Obese patients were found to have higher rates of infection and reoperation and less improvement from baseline function. Risk factors for reoperation included duration of pretreatment symptoms for longer than 12 months, increased age, multiple levels of stenosis, predominant back pain, no physical therapy, greater leg pain, the use of antidepressants and no neurogenic claudication upon enrollment.Conclusion.Ten years after its inception, SPORT has made strides in standardization and optimization of treatment for spinal pathologies. SPORT has provided clinicians with insight about outcomes of surgical and nonoperative treatment of spinal stenosis. Results showed significantly greater improvement through 4 year follow up in those patients that received surgical treatment, however the difference between the surgical and nonsurgical groups diminished at 8 year follow up.Level of Evidence: 3.
KW - SPORT
KW - spinal stenosis
KW - spine patient outcomes research trial
KW - surgical outcomes
UR - http://www.scopus.com/inward/record.url?scp=85085713516&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85085713516&partnerID=8YFLogxK
U2 - 10.1097/BRS.0000000000003323
DO - 10.1097/BRS.0000000000003323
M3 - Review article
C2 - 31770345
AN - SCOPUS:85085713516
SN - 0362-2436
VL - 45
SP - 832
EP - 836
JO - Spine
JF - Spine
IS - 12
ER -