Wrong Science: The SPORT Trial and Its Potential Impact on Neurosurgery

摘要

SPORT (Spine Patient Outcome Research Trial) is a 13.5 million dollar prospective, multicenter, randomized clinical trial (RCT) of surgical versus nonsurgical treatment of lumbar herniated disc, spinal stenosis, and degenerative spon-dylolisthesis. Although the study was developed with the intention of improving the care of patients with spinal disorders, several flaws in the study design and faulty assumptions regarding the spinal conditions threaten the validity and the generalizability of the study. It is critical that neurosurgeons recognize that, despite a prospective, multicenter, randomized design, SPORT will not definitively answer the question of how best to treat these disorders. In fact, SPORT may raise more controversy than it resolves as it is biased toward producing a null result.