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Lumbar Disk Herniation and SPORT

A Review of the Literature

Ilyas, Haariss, MD; Savage, Jason, MD

doi: 10.1097/BSD.0000000000000696

The Spine Patient Outcomes Related Trial (SPORT) is arguably one of the most impactful and insightful studies conducted in spine surgery. Designed as a prospective, multicenter study with a randomized and observational cohort, SPORT has provided vast data on the pathogenesis, treatment effects, clinical outcomes, cost effectiveness of both disk herniation and lumbar spinal stenosis. With regards to lumbar disk herniation, SPORT has demonstrated a sustained benefit from surgical intervention and acceptable cost-effectiveness at 2, 4, and 8 years postoperatively. Myriad subgroup analyses have subsequently been performed that have also resulted in clinically relevant findings. These analyses have assessed optimal timing for surgery, incidence and risk factors for reoperation, impact of obesity and other comorbidities, influence of epidural injections, and evaluation of socioeconomic factors. This has resulted in significant findings that may allow spine surgeons to optimize patient outcomes while managing expectations appropriately.

Department of Orthopaedic Surgery, Center for Spine Health, Cleveland Clinic, Cleveland, OH

The authors declare no conflict of interest.

Reprints: Haariss Ilyas, MD, Department of Orthopaedic Surgery, 9500 Euclio Ave Cleveland, OH 44106 (e-mail:

Received September 4, 2017

Accepted June 19, 2018

© 2018 by Lippincott Williams & Wilkins, Inc.