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Researchers cite gender-related differences in patients undergoing lumbar disc herniation surgery

Compared to their male counterparts, women said they experienced more back pain and a lower quality of life.

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BRUSSELS — Women patients who underwent surgery for a herniated lumbar disc generally fared worse than men in terms of back pain, general health and quality of life. The reasons for the difference remain unclear.

Björn Strömqvist, MD, of Lund University in Sweden, and his colleagues conducted a longitudinal study of patients who had lumbar disc herniation surgery at the same Swedish orthopaedic clinic. All 301 patients in the study group (165 males, 136 females) completed the protocols of the Swedish National Spine Surgery Register. Investigators analyzed preoperative, surgical and 1-year follow-up data.

Strömqvist reported his team’s findings at the 9th Annual Meeting of the Spine Society of Europe, here.

The mean patient age in both groups was 42 years, and all patients underwent surgery via either a microscope-assisted or open approach.

Females demonstrated more back pain based on Visual Analog Scores and inferior vitality, general health and mental health (SF-36) scores preoperatively, Strömqvist said.

Both men and women improved significantly in all pain-related scores postoperatively. However, more women used analgesics at follow-up and reported greater back and leg pain than the men. Likewise, more men reported satisfactory function levels (ie, Oswestry Disability Index score less than 20), and men had significantly higher quality of life (SF-36) scores regarding physical function, bodily pain and vitality.

Men and women reported comparable satisfaction levels with their outcomes, with 70% in both groups claiming they were satisfied with their surgery.

Strömqvist said that while these findings are intriguing, “Whether these differences represent true differences between the genders” remains to be seen.

Robert C. Mulholland, FRCS, of Nottingham, England, said it was a “very impressive paper” that forces surgeons to ask some “important questions” regarding how men and women interpret pain and postoperative function.

For more information:

• Strömqvist B, Ahmad M, Strömqvist F, et al. Gender differences in lumbar disc herniation surgery. #29. Presented at the 9th Annual Meeting of the Spine Society of Europe. Oct. 2-6, 2007. Brussels.