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  • The SPORT (Spine Patient Outcome Research Trial) compared outcomes for surgical and nonoperative treatment for lumbar disk herniations. It was published in 2006 in JAMA, but now we have over 10 years of data. Adherence to assigned treatment was limited: 50% of patients assigned to surgery received surgery within 3 months of enrollment, while 30% of those assigned to nonoperative treatment received surgery in the same period. Intent-to-treat analyses demonstrated substantial improvements for all primary and secondary outcomes in both treatment groups. Between-group differences in improvements were consistently in favor of surgery for all periods but were small and not statistically significant for the primary outcomes.