During this episode, Dr. Malanga will discuss an important randomized trial called the Spine Patient Outcomes Research Trial (SPORT) published in JAMA (2006). This research study enrolled 743 patients, of which 528 patients received surgery and 191 received nonoperative care for lumbar disk herniation at the 2-year mark. Also, we will be discussing an important topic on non-operative treatment options in particular epidural injections.  We will compare the efficacy and safety profile for transforaminal and interlaminar injections to help our future providers give their patients the best treatment option.  

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2562254/

Time Stamp:

· Opening remarks (0:29)

· Introduction to the Spine Patient Outcomes Research Trial (SPORT) by Dr. James Weinstein (1:55)

· Defining non-operative treatment for the SPORT research study (4:00)

· How could this study be improved? (6:15)

· Thoughts on non-operative treatment options like epidural injections (7:20)

· Comparing transforaminal vs. interlaminar epidural injections (8:15)

· Why are interlaminar injections not as popular? (10:10)

· Understanding how paralysis can occur with epidural injections (11:30)

· Is the transforaminal approach superior to the interlaminar approach? (12:35)

· Cervical versus lumbar interlaminar approach (16:15)

· Closing remarks (17:10)