Table 1.
Area under curve subgroup results for Oswestry Disability Index (ODI) change scores, adjusted for age, gender, center, and baseline ODI score (Time weighted average 4 years treatment effects).
| N | Surgical (n = 788) |
Non-operative (n = 404) |
Treatment Effect†(95% CI) | |
|---|---|---|---|---|
| Baseline ODI ≤ 31 | 258 | −21.4 (1.5) | −5.2 (1.2) | −16.1 (−19.1, −13.1) |
| 31 < Baseline ODI ≤ 45 | 252 | −29.4 (1.3) | −14.9 (1.4) | −14.5 (−17.5, −11.4) |
| 45 < Baseline ODI ≤ 60 | 293 | −39.2 (1.1) | −23.1 (1.6) | −16 (−19.3, −12.8) |
| Baseline ODI > 60 | 386 | −50.8 (1) | −39.1 (1.6) | −11.7 (−14.9, −8.4) |
| p-value | <0.001 | <0.001 | 0.18 | |
| Sciatica Bothersomeness ≤ 16 | 625 | −37.3 (0.8) | −25.4 (0.9) | −11.9 (−13.7, −10) |
| Sciatica Bothersomeness > 16 | 556 | −33.7 (0.8) | −21.5 (1.1) | −12.2 (−14.5, −10) |
| p-value | 0.001 | 0.006 | 0.82 | |
| Age <= 41 | 644 | −35.6 (0.7) | −25 (1) | −10.6 (−12.6, −8.6) |
| Age > 41 | 548 | −35.7 (0.8) | −22.5 (0.9) | −13.3 (−15.3, −11.2) |
| p-value | 0.89 | 0.06 | 0.06 | |
| Female | 507 | −35 (0.8) | −22.3 (1) | −12.7 (−14.9, −10.5) |
| Male | 685 | −36.1 (0.7) | −24.7 (0.9) | −11.4 (−13.2, −9.5) |
| p-value | 0.31 | 0.068 | 0.35 | |
| Body Mass Index < 30 | 854 | −38.1 (0.6) | −25.6 (0.8) | −12.4 (−14.1, −10.7) |
| Body Mass Index ≤30 | 336 | −29.9 (1) | −18.1 (1.3) | −11.9 (−14.5, −9.2) |
| p-value | <0.001 | <0.001 | 0.71 | |
| Reflex Asymmetry | 481 | −36 (0.8) | −25.1 (1.1) | −10.9 (−13.1, −8.6) |
| No Reflex Asymmetry | 710 | −35.4 (0.7) | −22.8 (0.9) | −12.6 (−14.4, −10.7) |
| p-value | 0.60 | 0.095 | 0.24 | |
| Positive Straight Leg Raise | 970 | −35.8 (0.6) | −24.2 (0.8) | −11.6 (−13.2, −10) |
| Negative Straight Leg Raise | 221 | −34.4 (1.4) | −22.9 (1.4) | −11.4 (−14.7, −8.2) |
| p-value | 0.35 | 0.42 | 0.93 | |
| No Joint Problem | 963 | −37.1 (0.6) | −24.5 (0.8) | −12.6 (−14.2, −11) |
| Joint Problem | 221 | −28.2 (1.3) | −20 (1.4) | −8.2 (−11.3, −5.1) |
| p-value | <0.001 | 0.005 | 0.01 | |
| Not Depressed | 1044 | −36.5 (0.6) | −24.5 (0.7) | −12 (−13.5, −10.4) |
| Depressed | 141 | −28.9 (1.6) | −16.4 (1.9) | −12.5 (−16.4, −8.5) |
| p-value | <0.001 | <0.001 | 0.82 | |
| No Other Comorbidities** | 666 | −38.1 (0.7) | −25.8 (0.9) | −12.3 (−14.2, −10.4) |
| Other Comorbidities | 526 | −32.3 (0.8) | −21.2 (1) | −11.2 (−13.2, −9.1) |
| p-value | <0.001 | <0.001 | 0.41 | |
| No Missed Work | 318 | −37.9 (1) | −26.9 (1.3) | −11 (−13.7, −8.4) |
| Missed Work | 724 | −34.8 (0.7) | −23.7 (0.9) | −11.1 (−13, −9.3) |
| p-value | 0.015 | 0.04 | 0.96 | |
| No Opiod Use | 520 | −38.6 (0.9) | −27 (1) | −11.6 (−13.7, −9.5) |
| Opiod Use | 542 | −34.8 (0.8) | −22.8 (1.1) | −12 (−14.3, −9.8) |
| p-value | 0.001 | 0.005 | 0.80 | |
| No Prior Injections | 625 | −37.7 (0.8) | −25.7 (0.9) | −12 (−13.9, −10.1) |
| Prior Injections | 567 | −33.5 (0.8) | −21.3 (1) | −12.2 (−14.3, −10) |
| p-value | <0.001 | 0.001 | 0.91 | |
| No Insurance | 38 | −20.1 (3.1) | −13.1 (4.7) | −7 (−16.9, 2.9) |
| Insured | 1151 | −36.1 (0.5) | −24.1 (0.7) | −12 (−13.4, −10.5) |
| p-value | <0.001 | 0.019 | 0.33 | |
| No Litigation | 1110 | −36.9 (0.5) | −24.9 (0.7) | −11.9 (−13.4, −10.4) |
| Litigation Pending/Resolved | 81 | −17.4 (2) | −7.7 (2.7) | −9.7 (−15, −4.4) |
| p-value | <0.001 | <0.001 | 0.42 | |
| Dissatisfied with Symptoms | 1134 | −35.7 (0.6) | −23.7 (0.7) | −12 (−13.5, −10.5) |
| Satisfied with Symptoms or Neutral | 57 | −33.4 (2.9) | −24.7 (2.6) | −8.7 (−14.8, −2.6) |
| p-value | 0.44 | 0.69 | 0.30 | |
| Predominant back pain | 221 | −31.9 (1.3) | −21.8 (1.4) | −10.1 (−13.1, −7.1) |
| Predominant leg pain | 962 | −36.4 (0.6) | −24 (0.8) | −12.4 (−14, −10.8) |
| p-value | 0.002 | 0.18 | 0.18 | |
| High school education or less | 287 | −32.2 (1.1) | −16.1 (1.4) | −16.1 (−19, −13.2) |
| At least some college or more | 884 | −36.8 (0.6) | −26.1 (0.8) | −10.7 (−12.3, −9) |
| p-value | <0.001 | <0.001 | 0.001 | |
| Sensory Deficit | 603 | −34.6 (0.7) | −22.3 (1) | −12.3 (−14.3, −10.3) |
| Sensory Intact | 588 | −36.8 (0.8) | −24.9 (0.9) | −11.9 (−13.9, −9.9) |
| p-value | 0.046 | 0.055 | 0.78 | |
| Motor Deficit | 501 | −35.3 (0.8) | −23.8 (1.1) | −11.5 (−13.8, −9.2) |
| Motor Intact | 690 | −35.9 (0.7) | −23.8 (0.9) | −12.2 (−14, −10.4) |
| p-value | 0.56 | 1 | 0.66 | |
| Other Herniation Location | 272 | −32 (1.2) | −21.6 (1.3) | −10.4 (−13.3, −7.4) |
| Posterolateral Herniation | 919 | −36.6 (0.6) | −24.5 (0.8) | −12.1 (−13.7, −10.4) |
| p-value | <0.001 | 0.055 | 0.31 | |
| No Stomach Problem | 1042 | −36.5 (0.6) | −24.4 (0.7) | −12.2 (−13.7, −10.6) |
| Stomach Problem | 142 | −28 (1.6) | −17.3 (1.9) | −10.7 (−14.6, −6.7) |
| p-value | <0.001 | <0.001 | 0.49 | |
| No Hypertension | 1022 | −36 (0.6) | −24.1 (0.7) | −11.9 (−13.5, −10.3) |
| Hypertension | 163 | −33.4 (1.5) | −20.3 (1.7) | −13.1 (−16.6, −9.5) |
| p-value | 0.11 | 0.042 | 0.55 | |
| No Antidepressants Use | 1011 | −37.3 (0.6) | −25.6 (0.7) | −11.8 (−13.3, −10.2) |
| Taking Antidepressants | 51 | −22.1 (2.6) | −14.1 (3.6) | −8 (−15.3, −0.7) |
| p-value | <0.001 | 0.002 | 0.32 | |
| No NSAID Use | 578 | −36 (0.8) | −24.9 (1) | −11.1 (−13.3, −9) |
| Taking NSAID | 484 | −37.4 (0.9) | −25.3 (1) | −12.1 (−14.3, −9.9) |
| p-value | 0.23 | 0.78 | 0.52 | |
| No Physical Therapy | 314 | −37.6 (1.1) | −24.7 (1.2) | −12.9 (−15.6, −10.2) |
| Had Physical Therapy | 878 | −35 (0.6) | −23.4 (0.8) | −11.6 (−13.3, −9.9) |
| p-value | 0.036 | 0.35 | 0.42 | |
| No Lifting at Work | 497 | −39.7 (0.8) | −27.7 (1) | −12 (−14.2, −9.8) |
| Lifting at Work | 694 | −32.8 (0.7) | −20.6 (0.9) | −12.2 (−14.1, −10.3) |
| p-value | <0.001 | <0.001 | 0.89 | |
| Worker's Compensation | 208 | −27.2 (1.2) | −18.2 (1.8) | −9 (−12.5, −5.5) |
| No Worker's Compensation | 981 | −37.5 (0.6) | −24.9 (0.7) | −12.6 (−14.2, −11) |
| p-value | <0.001 | <0.001 | 0.06 | |
| L2-L3 / L3-4 Herniation | 88 | −32.7 (2.3) | −22.7 (2.2) | −10.1 (−15.6, −4.5) |
| L4-L5 Herniation | 456 | −36.8 (0.9) | −23.7 (1.1) | −13 (−15.3, −10.8) |
| L5-S1 Herniation | 647 | −35.1 (0.7) | −24.2 (0.9) | −10.9 (−12.8, −8.9) |
| p-value | 0.14 | 0.80 | 0.30 | |
| Protruding Herniation | 322 | −34.3 (1) | −21.6 (1.2) | −12.8 (−15.3, −10.3) |
| Extruded Herniation | 783 | −35.5 (0.7) | −24.6 (0.9) | −11 (−12.8, −9.1) |
| Sequestered Herniation | 86 | −41.9 (2.1) | −25.6 (2.4) | −16.4 (−21.6, −11.2) |
| p-value | 0.004 | 0.084 | 0.11 | |
| 6 Weeks or Less Duration | 165 | −40.6 (1.5) | −30.7 (1.7) | −9.9 (−13.6, −6.2) |
| 1.5 to 6 Months Duration | 765 | −36.3 (0.7) | −24.8 (0.8) | −11.5 (−13.2, −9.7) |
| More than 6 Months Duration | 262 | −30.5 (1.1) | −15.8 (1.4) | −14.7 (−17.7, −11.7) |
| p-value | <0.001 | <0.001 | 0.09 | |
| Non-Smoker | 607 | −37.8 (0.8) | −25.7 (0.9) | −12.2 (−14.1, −10.2) |
| Ex-Smoker | 298 | −35.1 (1.1) | −24.1 (1.3) | −11.1 (−13.8, −8.3) |
| Smoker | 282 | −31.2 (1.1) | −17.9 (1.4) | −13.3 (−16.3, −10.3) |
| p-value | <0.001 | <0.001 | 0.57 | |
| White | 1033 | −36.2 (0.6) | −24.9 (0.7) | −11.4 (−12.9, −9.8) |
| Black | 75 | −28 (2.5) | −12.8 (2.4) | −15.2 (−21, −9.4) |
| Other Race | 84 | −34.1 (2) | −21 (2.6) | −13.1 (−18.4, −7.8) |
| p-value | 0.004 | <0.001 | 0.40 | |
| Married | 835 | −36.9 (0.6) | −22.7 (0.8) | −14.2 (−15.9, −12.5) |
| Divorced/Widowed | 130 | −29.1 (1.6) | −18.9 (2.1) | −10.3 (−14.5, −6) |
| Single | 212 | −35.4 (1.4) | −30.1 (1.6) | −5.2 (−8.5, −2) |
| p-value | <0.001 | <0.001 | <0.001 | |
| Not working | 206 | −33.5 (1.3) | −18.8 (1.5) | −14.7 (−18, −11.4) |
| Income Over $50,000 | 446 | −38.7 (0.9) | −28.3 (1.1) | −10.4 (−12.8, −8.1) |
| Income Under $50,000 | 535 | −34 (0.8) | −22.2 (1) | −11.9 (−14, −9.8) |
| p-value | <0.001 | <0.001 | 0.11 | |
| Problem getting better | 179 | −42.3 (1.6) | −29.8 (1.4) | −12.4 (−15.8, −9.1) |
| Problem staying about the same | 534 | −35.8 (0.8) | −25.1 (1) | −10.7 (−12.8, −8.6) |
| Problem getting worse | 472 | −32.9 (0.8) | −17.5 (1.3) | −15.4 (−18, −12.9) |
| p-value | <0.001 | <0.001 | 0.02 | |
| Baseline MCS <= 35 | 263 | −30.2 (1.2) | −16.4 (1.4) | −13.9 (−16.9, −10.8) |
| Baseline MCS > 35 | 927 | −37 (0.6) | −26 (0.8) | −11 (−12.6, −9.4) |
| p-value | <0.001 | <0.001 | 0.10 | |
†
Treatment effect is the difference between the surgical and non−operative mean change from baseline.
**
Other comorbidities include: stroke, diabetes, osteoporosis, cancer, fibromyalgia, cerebrospinal fluid leak, PTSD, alcohol, drug dependency, heart, lung, liver, kidney, blood vessel, nervous system, hypertension, migraine, anxiety, stomach, or bowel problems.