This is a 5-year multicenter prospective study involving about 2500 patients with three common spinal conditions -Prolapse Lumbar intervertebral disc, Spinal stenosis, and degenerative Spondylolisthesis. 13 centers across the United stated participated in this trial.

Results of this study published in three phases.

  1. To asses, the efficacy of Lumbar discectomy over nonsurgical treatments for Lumbar disc prolapse                           Published in JAMA, 2006                                                                                                                                                             Nonoperative treatments studied include- Medication, Physiotherapy, Chiropractor, Acupuncture, and injections. Surgical treatment Discectomy and decompression.                                                                                         Study conclusion – Discectomy resulted in more rapid improvement in symptoms and better results and patient satisfaction at 2 years follow up.
  2.   The second phase assessed a group of patients with degenerative Spondylolisthesis and the results published in the New England Journal of Medicine in 2007. The study concluded that patients who were treated surgically shown greater improvement in pain and function. By end of 4 years, two-thirds of patients decided to have surgery to address their back and leg pain.
  3. The third group is patients with Lumbar Spinal stenosis and results published in The New England Journal of Medicine in 2008. Patients who were treated surgically demonstrated greater improvement in function and pain at 2 years follow up.