SPINESCAN LITERATURE REVIEW
Issue 1, Volume 1
Implications of the SPORT Study
Recent Research on Operative and Non-operative Spine Care

Introduction

Recent Research on Operative and Non-operative Spine Care

Welcome from Jason Highsmith, MD

It has been nearly 6 years since the Spine Patient Outcomes Research Trial (SPORT) study put back pain on the mainstream radar for research and outcomes measures.  The study has been highly criticized for:

  1. immediate exclusion of patients clearly needing surgery
  2. dated therapies and surgical treatments (no MIS techniques)
  3. nebulous non-operative treatment options (50+ medication options)
  4. most importantly, the "intent-to-treat" analysis confounded by high crossover rates.

Regardless, the study has reinvigorated the spine community to follow more rigorous clinical pathways and better assess outcomes in clinical practice.  In this edition of SpineScan, we present 6 recent papers, each addressing a stage in the clinical acumen of spine surgery.

  • Improving accuracy in the physical exam
  • Assessing efficacy of interventional (non-surgical) treatments
  • Determining the proper place for epidural steroid injections
  • Evaluating cost-benefit analysis of therapies
  • Reviewing evidence based outcomes
  • Reconciling differences in clinical decision making
First Article:
The Accuracy of the Physical Examination for the Diagnosis of Midlumbar and Low Lumbar Nerve Root Impingement
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