NERVESThe Lancet. Rheumatology 2021
Surgical microdiscectomy versus transforaminal epidural steroid injection in patients with sciatica secondary to herniated lumbar disc (NERVES): a phase 3, multicentre, open-label, randomised controlled trial and economic evaluation
Disability at 18 weeks did not differ significantly between injection and microdiscectomy, and injection was the cheaper first-line option on economic evaluation.
Randomised trialManagementSpine
PRECISE (pregabalin for sciatica)The New England journal of medicine 2017
Trial of Pregabalin for Acute and Chronic Sciatica
Pregabalin did not significantly reduce leg pain compared with placebo at 8 weeks or at 1 year, and caused more adverse events such as dizziness.
Randomised trialManagementSpine
SPORT spinal stenosisThe New England journal of medicine 2008
Surgical versus nonsurgical therapy for lumbar spinal stenosis
In as-treated analysis surgery gave significantly greater improvement in pain and function at 2 years; intention-to-treat analysis showed a significant benefit only for bodily pain because of crossover.
Randomised trialManagementSpine
Peul sciatica trial (Sciatica Trial)The New England journal of medicine 2007
Surgery versus prolonged conservative treatment for sciatica
Early surgery produced faster relief of leg pain and faster perceived recovery, but by 1 year outcomes were similar between groups; a substantial proportion of the conservative group eventually had surgery.
Randomised trialManagementSpine
MRC Spine Stabilisation TrialBMJ (Clinical research ed.) 2005
Randomised controlled trial to compare surgical stabilisation of the lumbar spine with an intensive rehabilitation programme for patients with chronic low back pain: the MRC spine stabilisation trial
Fusion produced only a small difference in Oswestry score of borderline significance, with no meaningful advantage in walking, while carrying surgical risk and greater cost.
Randomised trialManagementSpine
Patchell MSCC trialLancet (London, England) 2005
Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial
Surgery plus radiotherapy significantly improved the proportion able to walk and the duration of walking, and more patients who were non-ambulant at presentation regained walking; corticosteroid and opioid needs were also lower.
Randomised trialManagementSpine