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Review
. 1996 Feb 1;21(3):259-63.
doi: 10.1097/00007632-199602010-00001.

Classics in Spine. Surgery literature revisited

L Bessette  1 , M H Liang, R A Lew, J N Weinstein
Affiliations
Review

Classics in Spine. Surgery literature revisited

L Bessette et al. Spine (Phila Pa 1976). .

Abstract

Study design: This article reviews the criteria for evaluating the quality of clinical trials.

Objectives: To outline the current methodologic standards by which the validity of controlled trials need to be evaluated.

Summary of background data: Weber's study, published in 1983 in Spine, is the only randomized trial comparing surgery and conservative management of sciatica in herniated lumbar discs.

Methods: Weber's article is revisited to illustrate basic principles in the design of clinical trials.

Results: Weber's study is a classic in spine surgery and has changed thinking regarding the benefit of surgery in sciatica related to herniated lumbar discs. However, the authors found potentially critical flaws in this study: a large number of crossovers, inadequate sample size, and insensitive outcome measurements.

Conclusions: A randomized, controlled trial is the most rigorous way to evaluate health intervention. Despite the difficulties of performing such studies, investigators should use the most appropriate scientific methodology.

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