Systematic Review of Outcomes Following 10-Year Mark of Spine Patient Outcomes Research Trial (SPORT) for Degenerative Spondylolisthesis
| Autor: | Jayson Lian, Nicole L. Levine, Brittany A. Oster, Woojin Cho, Sina Rashidi Kikanloo |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Time Factors Neurogenic claudication law.invention 03 medical and health sciences Postoperative Complications Spinal Stenosis 0302 clinical medicine Randomized controlled trial law Outcome Assessment Health Care medicine Humans Orthopedics and Sports Medicine Aged Pain Measurement Randomized Controlled Trials as Topic 030222 orthopedics Lumbar Vertebrae business.industry Evidence-based medicine Middle Aged medicine.disease Low back pain Spondylolisthesis Oswestry Disability Index Treatment Outcome Systematic review Physical therapy Female Neurology (clinical) medicine.symptom Outcomes research business Low Back Pain 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Spine. 45:820-824 |
| ISSN: | 1528-1159 0362-2436 |
| Popis: | Study design We performed a comprehensive search of PubMed, MEDLINE, and EMBASE for all English language studies of all levels of evidence pertaining to Spine Patient Outcomes Research Trial (SPORT), in accordance with Preferred Reported Items for Systematic Reviews and Meta-analyses guidelines. Objective We aim to summarize the 10-year clinical outcomes of SPORT and its numerous follow-up studies for degenerative spondylolisthesis. Summary of background data The SPORT was a landmark randomized control trial including approximately 2500 patients at 13 clinics across the country. SPORT compared surgical and nonoperative management of the three most common spinal pathologies. Methods Keywords used in the literature search included SPORT, spine patient outcomes research trial, degenerative spondylolisthesis, and surgical outcomes. Results The intent-to-treat analysis failed to show a significant difference between patients treated surgically as compared to those treated nonoperatively. However, as-treated analysis revealed statically greater improvements at 6 weeks, 2 years, and 4 years in patients treated surgically. Secondary outcomes such as low back pain, leg pain, stenosis bothersome scales, overall satisfaction with current symptoms, and self-rated progress were also significantly improved in surgical patients. Regardless of the initial grade of listhesis, disk height, or mobility, patients who had surgical treatment improved more in terms of Oswestry Disability Index, bodily pain, physical function, and low back pain bothersomeness scales. Risk of reoperation increased with age, having two or three moderate or severe stenotic levels, pain predominantly localized to the back, no physical therapy, the absence of neurogenic claudication, and greater leg pain scores. Risk of reoperation was not significantly affected by type of surgery performed, smoking, diabetes, obesity, longer duration of symptoms, or workman's compensation. Conclusion Although intent-to-treat analysis failed to show significant differences in patients treated surgically, results of the as-treated analysis determined statically greater improvements in those patients with spondylolisthesis who were treated surgically as compared to those treated nonoperatively. Level of evidence 2. |
| Databáze: | OpenAIRE |
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