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Sex differences in lumbar degenerative disc disease
Oliver P Gautschi1, Nicolas R Smoll2, Marco V Corniola1
1Department of Neurosurgery and Faculty of Medicine, University Hospital Geneva, Geneva, Switzerland.
Clinical Neurology and Neurosurgery
|April 18, 2016
Summary
Female patients with lumbar degenerative disc disease report worse pain and disability pre-surgery, but achieve similar outcomes to men after surgery. Objective functional impairment (OFI) may be a less biased measure of disability.
Area of Science:
- Spine surgery
- Orthopedics
- Degenerative Disc Disease
Background:
- Sex differences in pre- and postoperative outcomes for lumbar degenerative disc disease (DDD) are increasingly studied.
- The underlying pathomechanisms for these sex differences remain unclear.
Purpose of the Study:
- To investigate preoperative and postoperative sex differences in patients with lumbar DDD undergoing surgery.
- To compare subjective functional impairment (SFI) and objective functional impairment (OFI) between sexes.
Main Methods:
- Prospective, two-center study of 214 patients undergoing lumbar spine surgery.
- Assessed pain (VAS), disability (ODI, RMD), and quality of life (EuroQol 5D, SF12).
- Objective functional impairment (OFI) measured using the timed-up-and-go (TUG) test; responder status defined by minimally clinically important differences.
Main Results:
- Preoperatively, females reported worse pain and subjective functional impairment (SFI) but similar objective functional impairment (OFI).
- At 6-week follow-up, sex differences in SFI and OFI resolved.
- No significant sex differences observed in improvement of pain, function, or quality of life at 6 weeks, 6 months, and 1 year post-surgery.
Conclusions:
- Objective functional impairment (OFI) may be a more reliable, less sex-biased indicator of disability in lumbar DDD.
- Despite worse preoperative subjective symptoms, female patients achieve comparable surgical outcomes to males.
- Surgical intervention effectively mitigates preoperative sex-related disparities in functional status and quality of life.
