This is a presentation on critical appraisal of SPORT RCT using the Graphic Approach to Epidemiology (GATE). It was presented at the Research methodology workshop at IOACON 2016, Kochi.
The SPORT study was a large multicenter randomized controlled trial comparing discectomy versus nonoperative care for lumbar disc herniations. The results of this study are analyzed critically. The study was marred with a high cross over rate making the interpretation of the results confusing. However, it is a landmark paper, and great lessons can be learned by critically analyzing the results.
I find the GATE framework quite useful for critical appraisal of epidemiological studies. This method was developed by Prof. Rod Jackson from New Zealand.
For more details on how to use the GATE framework for critical appraisal, click on the links below:
This presentation summaries current literature on nonoperative versus operative treatment for lumbar disc herniation.
This is a surgical video of minimally invasive microdiscectomy.
This is a common operation performed for persistent, severe sciatica due to lumbar disc herniation. Open microdiscectomy is the traditional way for performing this surgery, however, in the recent times, a minimally invasive approach has gained popularity.
Potential advantages of minimally invasive microdiscectomy are limited muscle injury, lesser pain and a shorter hospital stay.
Here we demonstrate a minimally invasive tubular microdiscectomy in a 22-year-old woman with right lower extremity radiculopathy of 6 months duration secondary to a right sided L4-5 disc herniation.