SPORT study leads to no conclusions

Implications: The conclusion of the SPORT study comes short of favoring one treatment over another. One thing that was clear from the study was the equivalence of the two treatment options.

This study has no implications on cost of care, as the differential cost of the two treatment options was not studied. This study, then, does not help in health care policy decisions, or in decisions related to reimbursement considerations.

This study has no implications regarding other types of spine surgery such as spinal fusion. The published data so far addresses only open diskectomy procedures. There should be no confusion regarding this very important distinction. The SPORT study data regarding spinal fusion is probably one to two years away from publication.

Analysis: The results of the SPORT do not support any conclusions regarding the superiority of the two treatment options, from an intent-to-treat analysis. The high rate of crossover, and the lack of statistical significance, prevents any solid conclusions along the study design.

The SPORT study does indeed support the practice of offering patients the freedom of informed choice among various treatment options. The choice of treatment for the practitioner is clinical. The choice for the patient, however, is much more complex, involving social, personal, cultural, behavioral, psychosocial, economical, and circumstantial factors.

Lumbosacral radiculopathy is a painful condition, and pain is very personal and the perception of it is highly variable. This makes the clinical end point of treating this condition somewhat elusive to quantify and imperatively tailored to the individual patient.