Gender differences as an influence on patients' satisfaction rates in spinal surgery of elderly patients

There is an increased rate of lumbar spinal operations in elderly patients due to lumbar spinal stenosis. Many factors affect the decision of the patient and surgeon to perform the operation, among which are the age of the patient, comorbidities and willingness to undergo surgery. However, the gender of the patient is rarely taken into consideration as a factor for performing the operation. The satisfaction of the patient is an important factor to assess the operative success retrospectively. Therefore, we assessed the differences caused by gender on the satisfaction of elderly patients following lumbar spinal surgery. Three hundred and sixty-seven elderly patients (>65 years) treated in our institution from 1990 to 2000 for lumbar spinal stenosis and who underwent laminectomy without fusion filled in a questionnaire prior to operation regarding their gender, demographic status, comorbidities, activities of daily living (ADL) using the Barthel index, and pain according to visual analogue scale. At follow-up, a telephone interview on 298 patients was structured and included the same pre-operative questions and additional questions regarding the satisfaction rate from surgery. Two hundred and ninety-eight patients responded to our telephone interview with a minimum follow-up of 1 year (mean: 64 months). After surgery, both women and men showed improvement in their ADL, and reduction in pain perception. The number of very satisfied patients was similar in both groups, but women were significantly more dissatisfied with the operation. The surgical parameters, including complications, did not differ between the groups. Gender differences were found to influence the satisfaction rate of lumbar spinal stenosis surgery. Women tend to have less satisfactory results than men. The reasons for that are probably multifactorial and are not related to the surgery per se.