European Spine Journal

, Volume 15, Issue 5, pp 677–682 | Cite as

Sexual function in men and women after anterior surgery for chronic low back pain

  • Olle Hägg
  • Peter Fritzell
  • Anders Nordwall
  • The Swedish Lumbar Spine Study Group
Original Article

Abstract

Sexual dysfunction after anterior lumbar fusion has mainly been focused on male biological function (retrograde ejaculation). The aim of the present study is to assess the effect of fusion surgery for chronic low back pain on the sex-related quality of life. Apart from routine prospective questionnaires, additional gender-specific mailed questionnaires produced retrospective data on sexual enjoyment and function after 2 years of follow-up. Patients randomised to non-surgical treatment and anterior or posterior fusion were compared. We found that surgically treated patients had a significantly better sex life than those non-surgically treated. The improved sex life was significantly associated with the reduced back pain. The improvement after anterior fusion, however, was counteracted by a trend towards disturbed orgasm and genital sensation in women, and a significant disturbance of ejaculation and genital sensation in men. In view of the increased frequency of anterior lumbar surgery with the strong promotion of disc replacement, the findings in the present small retrospective pilot study should be tested in larger prospective trials.

Keywords

Sexual dysfunction Orgasm Ejaculation Spinal fusion Low back pain 

References

  1. 1.
    Blumenthal SL, Baker J, Dossett A, Selby DK (1988) The role of anterior lumbar fusion for internal disc disruption. Spine 13:566–569PubMedGoogle Scholar
  2. 2.
    Christensen FB, Bunger CE (1997) Retrograde ejaculation after retroperitoneal lower lumbar interbody fusion. Int Orthop 21:176–180CrossRefPubMedGoogle Scholar
  3. 3.
    Cohn EB, Ignatoff JM, Keeler TC, Shapiro DE, Blum MD (2000) Exposure of the anterior spine: technique and experience with 66 patients. J Urol 164:416–418Google Scholar
  4. 4.
    Escobar E, Transfeldt E, Garvey T, Ogilvie J, Graber J, Schultz L (2003) Video-assisted versus open anterior lumbar spine fusion surgery: a comparison of four techniques and complications in 135 patients. Spine 28:729–732CrossRefPubMedGoogle Scholar
  5. 5.
    Fritzell P, Hagg O, Wessberg P, Nordwall A (2001) 2001 Volvo Award Winner in Clinical Studies: lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish Lumbar Spine Study Group. Spine 26:2521–2532 (discussion pp2532–2524)CrossRefPubMedGoogle Scholar
  6. 6.
    Fritzell P, Hagg O, Wessberg P, Nordwall A (2002) Chronic low back pain and fusion: a comparison of three surgical techniques: a prospective multicenter randomized study from the Swedish lumbar spine study group. Spine 27:1131–1141CrossRefPubMedGoogle Scholar
  7. 7.
    Kaiser MG, Haid RW Jr, Subach BR, Miller JS, Smith CD, Rodts GE Jr (2002) Comparison of the mini-open versus laparoscopic approach for anterior lumbar interbody fusion: a retrospective review. Neurosurgery 51:97–103 (discussion pp103–105)CrossRefPubMedGoogle Scholar
  8. 8.
    Kleeman TJ, Ahn UM, Talbot-Kleeman A (2001) Laparoscopic anterior lumbar interbody fusion with rhBMP-2: a prospective study of clinical and radiographic outcomes. Spine 26:2751–2756CrossRefPubMedGoogle Scholar
  9. 9.
    Loguidice VA, Johnson RG, Guyer RD, Stith WJ, Ohnmeiss DD, Hochschuler SH, Rashbaum RF (1988) Anterior lumbar interbody fusion. Spine 13:366–369PubMedGoogle Scholar
  10. 10.
    McAfee PC, Regan JJ, Geis WP, Fedder IL (1998) Minimally invasive anterior retroperitoneal approach to the lumbar spine. Emphasis on the lateral BAK. Spine 23:1476–1484CrossRefPubMedGoogle Scholar
  11. 11.
    Newman MH, Grinstead GL (1992) Anterior lumbar interbody fusion for internal disc disruption. Spine 17:831–833PubMedGoogle Scholar
  12. 12.
    Rajaraman V, Vingan R, Roth P, Heary RF, Conklin L, Jacobs GB (1999) Visceral and vascular complications resulting from anterior lumbar interbody fusion. J Neurosurg 91:60–64PubMedGoogle Scholar
  13. 13.
    Regan JJ, Aronoff RJ, Ohnmeiss DD, Sengupta DK (1999) Laparoscopic approach to L4-L5 for interbody fusion using BAK cages: experience in the first 58 cases. Spine 24:2171–2174CrossRefPubMedGoogle Scholar
  14. 14.
    Sasso RC, Kenneth Burkus J, LeHuec JC (2003) Retrograde ejaculation after anterior lumbar interbody fusion: transperitoneal versus retroperitoneal exposure. Spine 28:1023–1026CrossRefPubMedGoogle Scholar
  15. 15.
    Tiusanen H, Seitsalo S, Osterman K, Soini J (1995) Retrograde ejaculation after anterior interbody lumbar fusion. Eur Spine J 4:339–342CrossRefPubMedGoogle Scholar
  16. 16.
    Vazquez RM, Gireesan GT (2003) Balloon-assisted endoscopic retroperitoneal gasless (BERG) technique for anterior lumbar interbody fusion (ALIF). Surg Endosc 17:268–272PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Olle Hägg
    • 1
    • 2
  • Peter Fritzell
    • 1
    • 2
  • Anders Nordwall
    • 1
    • 2
  • The Swedish Lumbar Spine Study Group
  1. 1.Department of OrthopaedicsSahlgrenska University HospitalGöteborgSweden
  2. 2.Department of OrthopaedicsFalu LasarettFalunSweden

Personalised recommendations