Gender-Based Analysis of Perioperative and Early Postoperative Complications in Tubular Microdiscectomy for Lumbar...

Various anthropometric differences and co-morbidities have been associated with disparities in postoperative outcomes following spinal surgery. Gender has been identified in previous studies as a potential factor influencing the prevalence of conditions like lumbar disc radiculopathy, degenerative disc disease, and cauda equina syndrome. Our study aimed to evaluate the effect of gender as a risk factor on the rate of perioperative and early postoperative complications after tubular microdiscectomy for lumbar disc prolapse.

This retrospective multicenter study, conducted in two specialized spine centers in Baghdad, Iraq, involved 302 patients with lumbar disc herniation (174 males and 128 females) from January 2016 to January 2022. Data collection included comprehensive assessments of clinical and surgical outcomes, utilizing the Core Outcome Measures Index (COMI) score at 2, 6, and 12 weeks.

A total of 134 males (77%) and 104 females (81%) were below 40 years old, while 40 males (23% of males) and 24 females (18.8% of females) were 40 or older. There was a significant difference in mean operative times (p < 0.001). The most common specific complication was spondylodiscitis with six males (3.4% of males) and three females (2.3% of females), while the most common general complication was post-op back spasm with six males (3.4% of males) and four females (3.1% of females). It's noteworthy to emphasize that our analysis showed a non-significant association of gender with the presence of either specific or general complications (p > 0.05).

Gender has a minimal impact on most perioperative and early postoperative complications. Longer operative times in females raise questions about gender-specific differences across spine surgeries and specialties, necessitating further research. We also note a shift in the age profile for disc prolapse patients, emphasizing the need for additional research into contributing factors among younger populations.