Newswise — The May 31, 2007 edition of the New England Journal of Medicine published results of the SPORT phase-two study, analyzing outcomes of patients with lumbar degenerative spondylolisthesis. SPORT is a multi-million dollar, federally funded, multi-center, prospective, randomized controlled trial designed to investigate the efficacy of surgery for patients with confirmed diagnoses of intervertebral disk herniation, spinal stenosis, and lumbar degenerative spondylolisthesis.
The latter condition is the forward displacement of one vertebra on another and most commonly affects people age 50 and older. Although this condition by itself is often asymptomatic, the 607 patients in this study all presented with neurogenic claudication or radicular leg pain with associated neurological signs, spinal stenosis, and degenerative spondylolisthesis confirmed on radiological studies. All patients experienced persistent symptoms for a minimum of 12 weeks and had been positively identified by their physicians as surgical candidates.
Two-thirds of those enrolled were women and the majority of patients were either retired or on Medicare. "This has significance for older people because there has been the persistent perception that spine surgery in this population may present too many risks and yield less positive outcomes than in younger patients," remarked Joseph T. Alexander, MD, chair of the AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves. "While any surgery involves increased risks among older patients, this study offers promise for properly selected patients who are suffering from these painful conditions and not achieving relief from conservative, nonsurgical treatment methods," said Dr. Alexander.
Patients treated with surgery in the SPORT study on lumbar degenerative spondylolisthesis not only experienced rapid and effective symptom relief but demonstrated both statistically significant and clinically important superior outcomes compared to patients treated nonsurgically on virtually all primary and secondary outcome measures. These substantial differences persisted at every follow-up time-point throughout the entire two-year study period. It is particularly noteworthy that the benefits of surgery were even greater in this study than demonstrated in the SPORT study on intervertebral disk herniation.
"This study demonstrates that in carefully selected patients with severe pain and disabling functional limitations from degenerative spondylolisthesis with stenosis, surgery reliably provides safe and highly effective outcomes with relief of pain, restoration of function, and a dramatically improved quality of life," said Douglas S. Kondziolka, MD, FRCSC, FACS, president of the CNS.
The AANS and CNS support rigorous scientific studies that seek to provide direction for the best patient care. Jon H. Robertson, MD, president of the AANS stated, "The neurosurgical community appreciates the difficulty of conducting these trials, and commends the National Institutes of Health for funding SPORT and the efforts of the investigators for undertaking such a comprehensive study. Our goal as neurosurgeons is to ensure that our patients continue to have access to treatments that provide relief for painful and often debilitating spinal conditions. We are committed to developing and delivering the most effective surgical and nonsurgical treatment options for our patients based on their individual circumstances."
Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 6,800 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS are certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons (Neurosurgery) of Canada, or the Mexican Council of Neurological Surgery, AC. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system, including the spinal column, spinal cord, brain, and peripheral nerves.
As an international organization representing over 6,500 neurosurgeons worldwide, the Congress of Neurological Surgeons (http://www.cns.org), a professional, medical association, exists for the purpose of promoting the public welfare through the advancement of neurosurgery, by a commitment to excellence in education and by dedication to research and scientific knowledge.
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