The effect of age and gender on acute postoperative pain and function following lumbar spine surgeries

Abstract

Background and Purpose Understanding the factors contributing to the variability in postoperative pain and function following lumbar spine surgeries (LSS) is necessary to plan inpatient rehabilitation and optimize surgical outcomes. In particular, variability due to age and gender has not been studied. This study's aim was to evaluate the variability in postoperative pain and function, during hospital stay, due to age and gender following LSS. Methods We conducted a retrospective analysis of 585 patients who underwent LSS during their hospital stay. Univariate ANCOVA was performed to study the differences in postoperative pain, and multivariate ANCOVA was performed to study the differences in postoperative function (gait distance, independency combined score, and balance combined score) between age groups (older adults [≥65 years of age] vs. younger adults) and gender. Results Younger patients reported statistically, but not clinically, significant higher postoperative pain than older patients (β = 0.652 [95% CI (0.382–0.986)], p < 0.001), and males reported statistically, but not clinically, significant lower postoperative pain than female patients (β = −0.583 [95% CI (−0.825 to −0.252)], p < 0.001) with adjustment of covariates. Male patients walked significantly longer distance than female patients (β = 0.272 [95% CI (0.112–0.432)], p = 0.001) with adjustment of covariates. However, these were clinically insignificant. With adjustment of preoperative diagnosis, type of surgery, severity of illness, and prior level of function, there was no statistically significant difference between age groups in walking distance, and between age and gender groups in independency combined score and balance combined scores. Discussion Following LSS, the difference in postoperative pain between age groups and gender are statistically but not clinically significant, suggesting patients require similar effective postoperative pain management regardless of age and gender. The apparent difference in age and gender in postoperative functional outcomes could be due to other factors.

The Potential Risk Factors for Prolonged Length of Stay Despite an Enhanced Recovery After Surgery Protocol for Elderly Patients Undergoing Short-Level Lumbar Fusion Surgery

“…20 Analogously, in a retrospective analysis of 585 patients who underwent lumbar spine surgery, Kanaan et al found male patients walked significantly longer distance than female patients, although clinically insignificant. 22 In our study, we found that age older than 75 years and females were independently related to prolonged LOS despite ERAS, which reminds us of the importance of age and gender on postoperative complications, and more attention should be paid to these patients in perioperative management to prevent postoperative complications. The increasing proportion of the aging population is generally associated with comorbidities and the postoperative complication rate following lumbar fusion surgery.…”

Prospective paired crossover evaluation of potential impact of investigator gender on perceived pain intensity early after acute or scheduled surgery

“…The lack of statistical difference in pain intensity levels between female and male study patients is in agreement with findings in small retrospective [ 52 ] and prospective [ 51 ] studies in postoperative patients. Contrarily, several studies during the last decade have reported higher pain intensity levels in females after various kinds of surgery [ 42 , 43 , 45 – 47 ], which might, at least in part, be due to higher pain intensity levels than in our study patients. However, an extensive review based on those results [ 53 ] found no consensus regarding associations between patient gender and postoperative pain intensity.…”

Prospective Evaluation of Local Sustained Release of Celecoxib in Dogs with Low Back Pain

“…Normal female dogs have a higher tactile sensitivity [ 48 , 49 ], and contradictory findings have been reported on mechanical and heat thresholds in normal female dogs compared to male dogs [ 49 ]. In line with this, women also tend to be more sensitive to pain [ 50 ], although the clinical significance appears to be low [ 51 ] and dependent on the interaction of multiple factors (i.e., anatomical, genetic, social) [ 52 ]. As such, in light of the relatively small study population (n = 30 dogs) of this RCT, the causes of this gender difference in clinical representation, and efficacy of the CXB-PEAM in providing analgesia and reducing interference of pain in daily activities, remain to be determined.…”