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Consider gender in selection of patients with lower back pain for fusion surgery

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AMSTERDAM — Although some research suggests a woman’s risk of a suboptimal outcome following lumbar spine surgery is many times higher than a man’s risk, a recent investigation found that women in the Swedish National Spine Register attained a similar quality of life and function as men 2 years after fusion surgery.

Y. Robinson, of Uppsala, Sweden, presented the findings at SpineWeek 2012, here.

The 1,945 men and 911 women that Robinson and a colleague studied underwent spine fusions between 2002 and 2007 in Sweden with the results tracked in the SweSpine register. The groups were fairly similar demographically at baseline; however, more of the women were smokers.

Y. Robinson

Following surgery “the women had the greatest improvement in all values, actually,” Robinson said.

Of note, the women all had worse baseline values nearly across the board compared to the men, including with the Oswestry Disability Index, EuroQual-5D, and Visual Analog Scale for leg pain and back pain, Robinson said during his presentation.

The women showed greater postoperative improvement than the men in all four of the key parameters used to assess their progress, according to the study results.

“If women have worse baseline values, do we operate on them too late?” Robinson said. “The data suggest a significant difference in patient gender with regard to surgical outcome of spinal fusion” and understanding this difference, he said, may lead to better selection of patients for surgery.

 Reference:

• Robinson Y, Sanden B. Pre- and postoperative QOL, pain and function after spinal fusion in chronic low back pain are gender dependent: 2-year results from SweSpine. Paper #21. Presented at SpineWeek 2012. May 28-June 1. Amsterdam.