Sex Differences in Patient-rated Outcomes After Lumbar Spinal Fusion for Degenerative Disease: A Multicenter Cohort Study.

Autor:	Ciobanu-Caraus O; Machine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Grob A; Machine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Rohr J; Machine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Stumpo V; Machine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Ricciardi L; Azienda Ospedaliera Universitaria Sant'Andrea, Department of NESMOS, Sapienza University, Rome, Italy., Maldaner N; Machine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Eversdijk HAJ; Department of Neurosurgery, Bergman Clinics Amsterdam, Amsterdam, The Netherlands., Vieli M; Machine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Raco A; Azienda Ospedaliera Universitaria Sant'Andrea, Department of NESMOS, Sapienza University, Rome, Italy., Miscusi M; Azienda Ospedaliera Universitaria Sant'Andrea, Department of NESMOS, Sapienza University, Rome, Italy., Perna A; Department of Orthopedics Foundation Casa Sollievo Della Sofferenza IRCCS, San Giovanni Rotondo (FG), Italy.; Department of Geriatrics and Orthopedics, Sacred Heart Catholic University, Rome, Italy., Proietti L; Department of Geriatrics and Orthopedics, Sacred Heart Catholic University, Rome, Italy.; Department of Aging, Neurological, Orthopedic and Head-Neck Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy., Lofrese G; Neurosurgery Division, Department of Neurosciences, 'M.Bufalini' Hospital Cesena, Italy., Dughiero M; Neurosurgery Division, Department of Neurosciences, 'M.Bufalini' Hospital Cesena, Italy., Cultrera F; Neurosurgery Division, Department of Neurosciences, 'M.Bufalini' Hospital Cesena, Italy., D'Andrea M; Neurosurgery Division, Department of Neurosciences, 'M.Bufalini' Hospital Cesena, Italy., An SB; Department of Neurosurgery, Spine and Spinal Cord Institute, Severance Hospital, College of Medicine, Yonsei University, Seoul, Korea., Ha Y; Department of Neurosurgery, Spine and Spinal Cord Institute, Severance Hospital, College of Medicine, Yonsei University, Seoul, Korea., Amelot A; Department of Neurosurgery, La Pitié Salpétrière Hospital, Paris, France.; Neurosurgical Spine Department, University Hospital of Tours, Tours, France., Cadelo JB; Department of Neurosurgery, Hospital Universitario La Paz, Madrid, Spain., Viñuela-Prieto JM; Department of Neurosurgery, Hospital Universitario La Paz, Madrid, Spain., Gandía-González ML; Department of Neurosurgery, Hospital Universitario La Paz, Madrid, Spain., Girod PP; Department of Neurosurgery, Vienna Healthcare Network / Landstrasse Municipial Hospital, Vienna, Austria., Lener S; Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria., Kögl N; Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria., Abramovic A; Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria., Laux CJ; University Spine Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland., Farshad M; University Spine Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland., O'Riordan D; Department of Teaching, Research and Development, Spine Center Division, Schulthess Klinik, Zurich, Switzerland., Loibl M; Department of Spine Surgery, Schulthess Klinik, Zurich, Switzerland., Galbusera F; Department of Teaching, Research and Development, Spine Center Division, Schulthess Klinik, Zurich, Switzerland., Mannion AF; Department of Teaching, Research and Development, Spine Center Division, Schulthess Klinik, Zurich, Switzerland., Scerrati A; Department of Neurosurgery, University Hospital Sant'Anna, Ferrara Italy., De Bonis P; Department of Neurosurgery, University Hospital Sant'Anna, Ferrara Italy., Molliqaj G; Department of Neurosurgery, HUG Geneva University Hospital, Geneva, Switzerland., Tessitore E; Department of Neurosurgery, HUG Geneva University Hospital, Geneva, Switzerland., Schröder ML; Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria., Stienen MN; Department of Neurosurgery & Spine Center of Eastern Switzerland, Cantonal Hospital St. Gallen & Medical School of St.Gallen, St. Gallen, Switzerland., Brandi G; Institute for Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland., Regli L; Machine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Serra C; Machine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Staartjes VE; Machine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Jazyk:	angličtina
Zdroj:	Spine [Spine (Phila Pa 1976)] 2024 Oct 17. Date of Electronic Publication: 2024 Oct 17.
DOI:	10.1097/BRS.0000000000005183
Abstrakt:	Study Design: Heterogeneous data collection via a mix of prospective, retrospective, and ambispective methods. Objective: To evaluate the effect of biological sex on patient-reported outcomes after spinal fusion surgery for lumbar degenerative disease. Summary of Background Data: Current literature suggests sex differences regarding clinical outcome after spine surgery may exist. Substantial methodological heterogeneity and limited comparability of studies warrants further investigation of sex-related differences in treatment outcomes. Methods: We analyzed patients who underwent spinal fusion with or without pedicle screw insertion for lumbar degenerative disease included within a multinational study, comprising patients from 11 centers in 7 countries. Absolute values and change scores (change from pe-operative baseline to post-operative follow-up) for 12-month functional impairment (Oswestry disability index [ODI]) and back and leg pain severity (numeric rating scale [NRS]) were compared between male and female patients. Minimum clinically important difference (MCID) was defined as > 30% improvement. Results: Six-hundred-sixty (59%) of 1115 included patients were female. Female patients presented with significantly baseline ODI (51.5 ± 17.2 vs. 47.8 ± 17.9, P<0.001) and back pain (6.96 ± 2.32 vs. 6.60 ± 2.30, P=0.010) and leg pain (6.49 ± 2.76 vs. 6.01 ± 2.76, P=0.005). At 12-months, female patients still reported significantly higher ODI (22.76 ± 16.97 vs. 20.50 ± 16.10, P=0.025), but not higher back (3.13 ± 2.38 vs. 3.00 ± 2.40, P=0.355) or leg pain (2.62 ± 2.55 vs. .34 ± 2.43, P=0.060). Change scores at 12 months did not differ significantly among male and female patients in ODI (∆ 1.31, 95% CI -3.88-1.25, P=0.315), back (∆ 0.22, 95% CI -0.57-0.12, P=0.197) and leg pain (∆ 0.16, 95% CI -0.56-0.24, P=0.439). MCID at 12-months was achieved in 330 (77.5%) male patients and 481 (76.3%) female patients (P=0.729) for ODI. Conclusion: Both sexes experienced a similar benefit from surgery in terms of relative improvement in scores for functional impairment and pain. Although female patients reported a higher degree of functional impairment and pain preoperatively, at 12 months only their average scores for functional impairment remained higher than those for their male counterparts, while absolute pain scores were similar for female and male patients. Competing Interests: Conflict of Interest: The authors declare that the article and its content were composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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