Evidence-based approach to lumbar disc herniation: Findings from the SPORT trial (primary and subgroup analyses)

The SPORT disc herniation study was the largest study ever performed comparing surgical and nonoperative outcomes for lumbar disc herniation. The study demonstrated that patients improved significantly with both surgery and nonoperative treatment; however, patients treated surgically improved faster and to a greater degree. These results were maintained through 8 years of follow-up. Subgroup analyses demonstrated that many patients and disease characteristics were associated with both surgical and nonoperative outcomes; however, very few predicted surgical treatment effect. All examined subgroups improved more with surgery than nonoperative treatment over 4 years of follow-up. Complications were relatively rare and tended not to affect long-term outcomes.