Women Do Not Have Poorer Outcomes After Minimally Invasive Lumbar Fusion Surgery: A Five-Year Follow-Up Study

Area of Science:

• Spine Surgery
• Orthopedics
• Neurosurgery

Background:

• Lumbar spine surgery outcomes can differ by sex, with women often reporting higher preoperative pain and disability.
• Existing literature on sex-based differences following minimally invasive surgery transforaminal lumbar interbody fusion (MIS TLIF) is limited.
• Investigating sex as a factor in MIS TLIF outcomes is crucial for personalized patient care.

Purpose of the Study:

• To determine if sex influences patient outcomes after MIS TLIF at a 5-year midterm follow-up.
• To compare preoperative and postoperative functional status and quality of life between males and females undergoing MIS TLIF.
• To identify any sex-specific trends in recovery and satisfaction after MIS TLIF.

Main Methods:

• Review of prospectively collected registry data from 907 patients who underwent MIS TLIF.
• Analysis of 296 patients (202 females, 94 males) with 5-year follow-up data.
• Assessment of Oswestry Disability Index (ODI), SF-36 Physical Component Scores (PCS), and Mental Component Scores (MCS) preoperatively and at 2 and 5 years postoperatively.

Main Results:

• Females were younger and had significantly worse preoperative ODI and SF-36 scores compared to males.
• At both 2-year and 5-year follow-ups, no significant differences in ODI, SF-36 scores, or pain levels were observed between sexes.
• Similar proportions of both sexes returned to work, regained function, and reported satisfaction with their outcomes.

Conclusions:

• Women undergoing MIS TLIF present with poorer preoperative function and quality of life than men.
• Despite initial disparities, women demonstrate greater functional improvement post-MIS TLIF.
• At 5-year follow-up, MIS TLIF yields comparable clinical outcomes for both sexes, indicating effective surgical management regardless of sex.