ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2018
Gender differences in degenerative spine surgery: Do female patients really fare worse?
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Gender equality challenges in orthopaedic surgery: a systematic review.International orthopaedics · 2023Pooled it
- Influence of gender and sexual hormones on outcomes after pituitary surgery: a systematic review and meta-analysis.Acta neurochirurgica · 2023Pooled it
- Initial classification of low back and leg pain based on objective functional testing: a pilot study of machine learning applied to diagnostics.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2020Pooled it
- Sex difference in outcomes and risk factors for lumbar decompressive surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Factors associated with preoperative health-related quality of life in patients undergoing lumbar spine surgery: a multi-ethnic Asian cohort.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- From preoperative to postoperative: gender differences in elective ventral hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Effect of Sociodemographic Differences on Elective Lumbar Fusion Surgery.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026Article
- Race, Ethnicity, and Gender Differences in Patient Reported Well-Being and Cognitive Functioning Within 3 Months of Symptomatic Illness During COVID-19 Pandemic.Journal of racial and ethnic health disparities · 2025Article
- Predictors of hospitalization for longer than one day following elective single-level anterior cervical discectomy and fusion: a retrospective case-control database study.Asian spine journal · 2025Article
- Malnutrition and Disability: A Retrospective Study on 2258 Adult Patients Undergoing Elective Spine Surgery.Medicina (Kaunas, Lithuania) · 2025Observational
- Prevalence of Neck Pain in Patients with Degenerative Cervical Myelopathy and Short-Term Response After Operative Treatment: A Cohort Study of 664 Patients From 26 Global Sites.Global spine journal · 2024Article
- Identifying clusters of objective functional impairment in patients with degenerative lumbar spinal disease using unsupervised learning.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- Impact of Gender on Postsurgical Outcomes in Patients Undergoing Anterior Cervical Discectomy and Fusion.International journal of spine surgery · 2022Article
- Impact of gender on outcomes following single-level anterior lumbar interbody fusion.Journal of clinical orthopaedics and trauma · 2022Article
- Sex differences in utilization and perioperative outcomes of arthroscopic rotator cuff repair.JSES international · 2022Article
- No Gender Differences in Pain Perception and Medication after Lumbar Spine Sequestrectomy-A Reanalysis of a Randomized Controlled Clinical Trial.Journal of clinical medicine · 2022Article
- Influence of dynamic preoperative body mass index changes on patient-reported outcomes after surgery for degenerative lumbar spine disease.Neurosurgical review · 2021Article
- The Influence of Sex on Clinical Outcomes in Minimally Invasive Lumbar Decompression.International journal of spine surgery · 2021Article
- The Perioperative Symptom Severity of Higher Patient Health Questionnaire-9 Scores Between Genders in Single-Level Lumbar Fusion.International journal of spine surgery · 2021Article
- Surgical Outcomes of Patients with Sacroiliac Joint Pain: An Analysis of Patients with Poor Results Regarding Activities of Daily Living.Spine surgery and related research · 2021Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePrior data has set the precedent that female patients fare somewhat worse than men after spine surgery. We aimed to evaluate the effect of gender on patient-reported outcomes after lumbar spine surgery for degenerative pathologies.
methodsWe identified a consecutive cohort of patients from a prospective registry. Absolute values, as well as change scores for back and leg pain severity (numeric rating scale [NRS]), functional disability (Oswestry disability index [ODI]), and health-related quality of life (HRQOL) as assessed by EQ-5D were compared among male and female patients.
resultsOf the 3279 included patients, 1543 (47%) were female. At baseline, women reported higher NRS for back and leg pain, higher ODI, but equal HRQOL (all p < 0.05). Otherwise, both groups had comparable baseline data. The absolute differences in patient-reported outcomes persisted at the 6-week, 12- and 24-months follow-up, with women now additionally reporting worse HRQOL as assessed by EQ-5D (all p < 0.05). For all outcome measures, change scores were equal among male and female patients, as were the incidences of complications and reoperations (all p > 0.05). Clinical success was achieved in 82% of men and 79% of women (p = 0.34).
conclusionsFemale patients are generally scheduled for surgery with a more advanced disease state. While women seem to report more severe symptoms at long-term follow-up, the degree of improvement is equal among men and women. Female patients may thus fare worse in terms of absolute scores, but enjoy the same benefit from surgery in relative terms. These slides can be retrieved under Electronic Supplementary Material.
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Registered trials
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