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Sponsors and Collaborators: |
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) National Institute for Occupational Safety and Health (NIOSH/CDC) Office of Research on Women's Health (ORWH) |
Information provided by: | National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) |
ClinicalTrials.gov Identifier: | NCT00000410 |
This study tests the effectiveness of different treatments for the three most commonly diagnosed lumbar (lower) spine conditions. The purpose of the study is to learn which of two commonly prescribed treatments (surgery and non-surgical therapy) works better for specific types of low back pain.
In this part of the study, people with lumbar intervertebral disc herniation (damage to the tissue between the bones of the lower spine, or backbone) will receive either discectomy (surgical removal of herniated disc material) or non-surgical treatment. This study does not cover the cost of treatment.
Condition | Intervention | Phase |
Herniated Disc Low Back Pain |
Procedure: Discectomy Procedure: Non-surgical treatments |
Phase IV |
MedlinePlus related topics: | Back Pain Hernia |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Efficacy Study |
Official Title: | Spine Patient Outcomes Research Trial (SPORT): A Multicenter Randomized Trial for Intervertebral Disc Herniation (IDH) |
Estimated Enrollment: | 500 |
Study Start Date: | March 2000 |
Estimated Study Completion Date: | November 2004 |
Low back pain is considered one of the most widely experienced health problems in the United States and the world. This condition is the second most frequent condition, after the common cold, for which people see a physician or lose days from work. Estimated costs to those who are severely disabled from low back pain range from $30-70 billion annually. Rates of spinal surgery in the U.S. have increased sharply over time, and researchers have documented 15-fold geographic variation in rates of these surgeries. In many cases, where one lives and who one sees for the problem appear to determine the rates of surgery. Despite these trends, there is little evidence proving the effectiveness of these therapies over non-surgical management.
Overall, the SPORT study is a multicenter, randomized, controlled trial for the three most common diagnostic groups for which spine surgery is performed: lumbar intervertebral disc herniation (IDH), spinal stenosis (SpS) and spinal stenosis secondary to degenerative spondylolisthesis (DS). This arm of the trial will deal with patients from the first diagnostic group. The study will compare the most commonly used standard surgical treatments to the most commonly used standard non-surgical treatments. We will conduct the study at 12 sites throughout the United States.
The primary endpoint of the study will be changes in health-related quality of life as measured by the SF-36 health status questionnaire. Secondary endpoints will include patient satisfaction with treatment, utility for current health in order to estimate quality-adjusted life years (QALYS) as the measure for cost-effectiveness, resource use, and cost.
We will follow patients at 6 weeks and 3, 6, 12, and 24 months to determine their health status, function, satisfaction, and use of health care. In this arm of the trial, we anticipate enrolling and randomly allocating a total of 500 participants. We will track an additional observational cohort to assess health and resource outcomes (1000 participants). Enrollment in the Observational cohort has been completed as of February 2003.
We will integrate data from the trial and observational cohorts to formally estimate the cost-effectiveness of surgical versus non-surgical interventions for IDH, SpS, and DS. On the basis of the results of this trial we will, for the first time, have scientific evidence as to the relative effectiveness of surgical versus non-surgical treatment for these three most commonly diagnosed lumbar spine conditions.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
United States, California | |||||
University of California, San Francisco | |||||
San Francisco, California, United States, 94143-0728 | |||||
Kaiser Permanente Spine Care Program | |||||
Oakland, California, United States, 94612 | |||||
United States, Georgia | |||||
The Emory Clinic, Emory University | |||||
Decatur, Georgia, United States, 30033 | |||||
United States, Illinois | |||||
Rush-Presbyterian, St. Luke's Medical Center | |||||
Chicago, Illinois, United States, 60612-3833 | |||||
United States, Maine | |||||
Maine Spine & Rehabilitation | |||||
Scarborough, Maine, United States, 04074 | |||||
United States, Michigan | |||||
William Beaumont Hospital | |||||
Royal Oak, Michigan, United States, 48073-9952 | |||||
United States, Missouri | |||||
Washington University | |||||
St. Louis, Missouri, United States, 63110 | |||||
United States, Nebraska | |||||
Nebraska Foundation for Spinal Research | |||||
Omaha, Nebraska, United States, 68154-4438 | |||||
United States, New Hampshire | |||||
Dartmouth-Hitchcock Medical Center - Spine Center | |||||
Lebanon, New Hampshire, United States, 03756 | |||||
United States, New York | |||||
Hospital for Special Surgery | |||||
New York, New York, United States, 10021 | |||||
New York University, The Hospital for Joint Diseases | |||||
New York, New York, United States, 10003 | |||||
United States, Ohio | |||||
Case Western Reserve University | |||||
Cleveland, Ohio, United States, 44106 | |||||
United States, Pennsylvania | |||||
Rothman Institute at Thomas Jefferson Hospital | |||||
Philadelphia, Pennsylvania, United States, 19107-4216 |
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) |
National Institute for Occupational Safety and Health (NIOSH/CDC) |
Office of Research on Women's Health (ORWH) |
Principal Investigator: | James N. Weinstein, DO, MS | Dartmouth-Hitchcock Medical Center |
Click here to view the Spine Patient Outcomes Research Trial (SPORT) Web site. 
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Study ID Numbers: | U01 AR45444 NIAMS-004C |
First Received: | November 3, 1999 |
Last Updated: | January 3, 2007 |
ClinicalTrials.gov Identifier: | NCT00000410 |
Health Authority: | United States: Federal Government |
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