Department of Orthopaedic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY.
Spine (Phila Pa 1976). 2020 Jun 15;45(12):825-831. doi: 10.1097/BRS.0000000000003400.
MINI: We summarized the 10-year outcomes of Spine Patient Outcomes Research Trial for intervertebral disc herniation through a systematic review. The observational cohort 2-year analysis and the as-treated analysis of the randomized control trial at 4 and 8 years showed statistically greater improvements in those patients who were treated surgically.
We performed a comprehensive search of Pubmed, MEDLINE, and EMBASE for English-language studies of all levels of evidence pertaining to SPORT, in accordance with Preferred Reported Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.
We aim to summarize the 10-year clinical outcomes of SPORT and its numerous follow-up studies for intervertebral disc herniation.
The Spine Patient Outcomes Research Trial (SPORT) was a landmark study. SPORT compared surgical and nonoperative management of the three most common spinal pathologies.
Keywords utilized included: SPORT, spine patient outcomes research trial, disc herniation, and surgical outcomes.
The observational cohort analysis revealed statically greater improvement in primary outcomes at 3 months and 2 years in patients who had surgery, while analysis of the randomized control trial cohort failed to show a significant difference based on the intent-to-treat principle due to significant patient crossover. However, 4 year and 8 year as-treated analysis showed statistically greater improvements in those patients who were treated surgically. SPORT's subgroup analysis evaluated important factors when considering the treatment of IDH, including patient characteristics, level of herniation, duration of symptoms, recurrence of pain, presence of retrolistheiss, patient functional status, effects of previous treatment with epidural steroid injections and opioid medication, outcomes after incidental durotomy, MRI reader reliability, reoperation rates, and risk factors for reoperation. The clinical impact of SPORT was also investigated and included comparison of SPORT patients to NSQIP patients to determine generalizability, outcome differences in SPORT's surgical center sites, patient preferences, patient expectations, level of education, and effects of watching an evidence-based video.
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 IDH. Results showed significantly greater improvements in patients treated surgically.
MINI：我们通过系统评价总结了脊柱患者结局研究试验（Spine Patient Outcomes Research Trial，SPORT）治疗椎间盘突出症的 10 年结果。观察队列的 2 年分析和随机对照试验的 4 年和 8 年实际治疗分析显示，手术治疗的患者在统计学上有更大的改善。
我们按照系统评价和荟萃分析的首选报告项目（Preferred Reported Items for Systematic Reviews and Meta-analyses，PRISMA）指南，对 Pubmed、MEDLINE 和 EMBASE 进行了全面检索，以查找与 SPORT 相关的所有证据水平的英语研究。
我们旨在总结 SPORT 及其多项椎间盘突出症后续研究的 10 年临床结果。
脊柱患者结局研究试验（Spine Patient Outcomes Research Trial，SPORT）是一项具有里程碑意义的研究。SPORT 比较了三种最常见脊柱病变的手术和非手术管理。
使用的关键词包括：SPORT、脊柱患者结局研究试验、椎间盘突出症和手术结果。
观察队列分析显示，手术组患者在 3 个月和 2 年时主要结局的改善具有统计学意义，而随机对照试验队列的分析由于患者大量交叉，未能基于意向治疗原则显示出显著差异。然而，4 年和 8 年的实际治疗分析显示，手术治疗的患者改善更为显著。SPORT 的亚组分析评估了在考虑 IDH 治疗时的重要因素，包括患者特征、椎间盘突出程度、症状持续时间、疼痛复发、存在后纵韧带骨化、患者功能状态、硬膜外类固醇注射和阿片类药物治疗的影响、意外硬脊膜切开后的结果、MRI 读者可靠性、再次手术率和再次手术的危险因素。还研究了 SPORT 的临床影响，包括将 SPORT 患者与 NSQIP 患者进行比较，以确定普遍性、SPORT 手术中心站点的结果差异、患者偏好、患者期望、教育水平以及观看基于证据的视频的影响。
在成立 10 年后，SPORT 在脊柱疾病的治疗标准化和优化方面取得了进展。SPORT 为临床医生提供了关于手术和非手术治疗 IDH 结果的见解。结果显示，手术治疗的患者改善更为显著。
3 级。
