Gender Differences in Pre- and Postoperative Health-Related Quality of Life Measures in Patients Who Have Had Decompression Surgery for Lumbar Spinal Stenosis

Abstract

Study Design: Retrospective chart audit.Purpose: This study aimed to investigate the gender difference in pre- and postoperative health-related quality of life (HRQOL) in patients who have had decompression surgery for lumbar spinal stenosis (LSS).Overview of Literature: Gender differences may contribute to variations in disease presentations and health outcomes. The influence of gender on pre- and postoperative HRQOL in spinal disorders remains unclear.Methods: We reviewed 125 patients (79 men and 46 women) who had lumbar spinous process splitting laminectomy (LSPSL) for LSS. We assessed the following clinical information: Japanese Orthopedic Association (JOA) score; numerical rating scale (NRS) for low back pain (LBP), leg pain, and leg numbness; Zurich Claudication Questionnaire; JOA Back Pain Evaluation Questionnaire; Roland- Morris Disability Questionnaire (RMDQ); and Short Form 8 (SF-8) as HRQOL. We compared the HRQOLs of men and women pre- and postoperatively.Results: Although the preoperative NRS results for LBP were significantly higher in women (p <0.05), there were no significant differences in clinical outcomes between men and women postoperatively. For HRQOL, the RMDQ scores were significantly worse in women preoperatively (p <0.05), but no significant differences were found postoperatively between men and women. Similarly, the SF-8 mental health score was also significantly lower in women preoperatively (p <0.05), but no significant differences were noted between the two groups postoperatively.Conclusions: LSPSL greatly reduced LBP, leg pain, and leg numbness in both genders. There were limited differences in pain and several HRQOL questionnaire responses between men and women after surgery. We found that women had greater sensitivity to and/or lower tolerance for pain than men, which led to lower HRQOL mental health scores preoperatively.

Sex differences in the consumption of over-the-counter analgesics among amateur volleyball players

“…These differences are not restricted to tactile perception and can be supposed for the whole body [82][83][84]. Regarding sex differences in clinical pain there are studies analysing pre-operative pain; a sex difference was found with greater pain scores for females than males [85][86][87][88][89], which was still detectable on the first post-operative day [86]. In terms of post-operative pain published data are inconsistent and depend partly on the time of the postoperative pain interviews [86,87,89].…”

Role of Gender in Improvement of Depressive Symptoms Among Patients Undergoing Cervical Spine Procedures

“…Few studies have established this relationship through direct comparison of mental health outcome measures and there is an even greater scarcity in the literature when considering the cervical spine population. Individuals who underwent procedures for lumbar spine pathologies were reported to differ based on gender with respect to pain, disability, and mental health scores, as measured by SF-8 MCS [ 8 ]. Although Kobayashi et al [ 8 ] established a significant preoperative difference between genders, it was not maintained throughout the entire postoperative period.…”

“…Individuals who underwent procedures for lumbar spine pathologies were reported to differ based on gender with respect to pain, disability, and mental health scores, as measured by SF-8 MCS [ 8 ]. Although Kobayashi et al [ 8 ] established a significant preoperative difference between genders, it was not maintained throughout the entire postoperative period. A similar result was demonstrated in our study with the exception that genders did not differ in their preoperative PHQ-9, SF-12 MCS, or VR-12 MCS score.…”

“…Earlier studies have provided insight into gender differences in depression severity among lumbar laminectomy patients and reported that women had lower tolerance for pain and worse mental health scores at the preoperative time point. 8 Conversely, investigators focusing on gender differences alone found no significant difference in pain, disability, and overall quality of life between men and women following lumbar procedures. 9 While earlier studies focused on gender differences in lower back pain studies, pathology of the cervical spine can also be associated with debilitating pain 10 and can be successfully treated with procedures such as anterior cervical discectomy and fusion (ACDF) or artificial disk replacement (ADR).…”

“…Earlier studies have provided insight into gender differences in depression severity among lumbar laminectomy patients and reported that women had lower tolerance for pain and worse mental health scores at the preoperative time point [ 8 ]. Conversely, investigators focusing on gender differences alone found no significant difference in pain, disability, and overall quality of life between men and women following lumbar procedures [ 9 ].…”