This proposed follow-up study is a competitive renewal of the Maine Lumbar Spine Study (MLSS). The MLSS, initially funded as part of the Low Back Pain PORT, enrolled over 600 patients with either sciatica or spinal stenosis in 1990/92. Patients were recruited through community-based physicians (orthopedists, neurosurgeons, and occupational medicine) for this observational study. The main goal was to compare patient-centered outcomes for patients who underwent surgery vs. those who did not. After extensive baseline data collection, patients have been resurveyed every year, with a good retention rate of approximately 80% of the surviving cohort at 8 years. The study has so far published 11 peer-reviewed papers with results of up to 5 years of follow-up. Data covering 8 years of follow-up have already been collected, years 9 and 10 are in process, and funding is requested to complete the 10 years of follow-up for all retained participants and to perform additional analyses. This application requests continued funding for 18 months, at a reduced level. The PI is based in Maine, which is the location of the cohort, and is now a consultant for the applicant organization. Subcontracts with MGH (Dr. Atlas), and the University of Washington (Dr. Deyo) are proposed, to continue collaborative efforts with investigators who have been involved with MLSS since its inception. Dr. Singer (MGH) is also proposed as a consultant, but not through the MGH subcontract.
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