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Weinstein 2010 — SPORT at four years

One-paragraph summary

SPORT enrolled surgical candidates with at least 12 weeks of symptomatic lumbar stenosis and confirmatory imaging into a 289-person randomized cohort and a 365-person observational cohort. Adjusted as-treated analyses through four years favored decompression by 12.6 points for SF-36 bodily pain (95% CI 8.5–16.7), 8.6 for physical function (4.6–12.6), and −9.4 ODI points (−12.6 to −6.2) (Weinstein 2010, PMID 20453723).

Key findings

  • The study combined randomized and preference-sensitive observational evidence.
  • Surgical advantages persisted through four years in adjusted as-treated analyses.
  • Effects were reported across pain, physical function and ODI rather than pain alone.
  • Crossover makes treatment-received estimates more clinically descriptive but less protected by randomization.

Limitations

  • High crossover weakened intention-to-treat contrast.
  • Nonoperative care was a strategy rather than a tightly standardized program.
  • Treatment choice and baseline preference may leave residual confounding in as-treated estimates.

Why it matters

SPORT established the modern evidence anchor for lumbar decompression while also becoming the field's clearest lesson in crossover and preference-sensitive trial interpretation.

Cited by wiki pages

  • Overview
  • Lumbar decompression