There is an increased rate of lumbar spinal operations in elderly patients due to lumbar spinal stenosis. Many factors affect the decision of the patient and surgeon to perform the operation, among which are the age of the patient, comorbidities and willingness to undergo surgery. However, the gender of the patient is rarely taken into consideration as a factor for performing the operation. The satisfaction of the patient is an important factor to assess the operative success retrospectively. Therefore, we assessed the differences caused by gender on the satisfaction of elderly patients following lumbar spinal surgery. Three hundred and sixty-seven elderly patients (>65 years) treated in our institution from 1990 to 2000 for lumbar spinal stenosis and who underwent laminectomy without fusion filled in a questionnaire prior to operation regarding their gender, demographic status, comorbidities, activities of daily living (ADL) using the Barthel index, and pain according to visual analogue scale. At follow-up, a telephone interview on 298 patients was structured and included the same pre-operative questions and additional questions regarding the satisfaction rate from surgery.Two hundred and ninety-eight patients responded to our telephone interview with a minimum follow-up of 1 year (mean: 64 months). After surgery, both women and men showed improvement in their ADL, and reduction in pain perception. The number of very satisfied patients was similar in both groups, but women were significantly more dissatisfied with the operation. The surgical parameters, including complications, did not differ between the groups. Gender differences were found to influence the satisfaction rate of lumbar spinal stenosis surgery. Women tend to have less satisfactory results than men. The reasons for that are probably multifactorial and are not related to the surgery per se.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Airaksinen O, Herno A, Turunen V, Saari T, Suomlainen O (1997) Surgical outcome of 438 patients treated surgically for lumbar spinal stenosis. Spine 22:2278–2282
An HS, Vaccaro A, Simeone FA, Balderston RA, O’Neill D (1990) Herniated lumbar disc in patients over the age of fifty. J Spinal Disord 3:143–146
Arinzon Z, Adunsky A, Fidelman Z, Gepstein R (2004) Outcomes of decompression surgery for lumbar spinal stenosis in elderly diabetic patients. Eur Spine J 13:32–37
Brattberg G, Parker MG, Thorslund M (1997) A longitudinal study of pain: reported pain from middle age to old age. Clin J Pain 13:144–149
Bush FM, Harkins SW, Harrington WG, Price DD (1993) Analysis of gender effects on pain perception and symptom presentation in temporomandibular joint pain. Pain 53:73–80
Cicero TJ, Nock B, Meyer ER (1997) Sex-related difference in morphine’s antinociceptive activity: relationship to serum and brain concentration. J Pharmacol Exp Ther 282:939–944
Coulthard P, Rood JP (1993) Anxiety during induced experimental pain. Anesth Pain Control Dent 2:150–153
Fillingim RB, Maixner W, Kincaid S, Silva S (1998) Sex differences in temporal summation but not sensory-discriminative processing of thermal pain. Pain 75:121–127
Fredman B, Arinzon Z, Zohar E, Shabat S, Jedeikin R, Fidelman ZG, Gepstein R (2002) Observation of the safety and efficacy of surgical decompression for lumbar spinal stenosis in geriatric patients. Eur Spine J 11:571–574
Friedmann JM, Elasy T, Jensen GL (2001) The relationship between body mass index and self-reported functional limitation among older adults: a gender difference. J Am Geriatr Soc 49:398–403
Gepstein R, Shabat S, Arinzon ZH, Berner Y, Catz A, Folman Y (2004) Does obesity affect the results of lumbar decompressive spinal surgery in the elderly? Clin Orthop 426:138–144
Gunzburg R, Keller TS, Szpalski M, Vandeputte K, Spratt KF (2003) Clinical and psychofunctional measures of conservative decompression surgery for lumbar spinal stenosis: a prospective cohort study. Eur Spine J 12:197–204
Guralnik MJ, Fried LP, Simonsick EM (1995) The Women’s Health and Aging Study: health and social characteristics of older women with disability. National Institute on Aging, NIH publication 95-4009, Bethesda, Md.
Herno A (1995) Surgical results of lumbar spinal stenosis. Ann Chir Gynaecol Suppl 210:1–969
Herno A, Airaksinen O, Saari T, Smovalainen O (1996) Pre- and postoperative factors associated with return to work following surgery for lumbar spinal stenosis. Am J Ind Med 30:473–478
Katz JN, Wright EA, Guadagnoli E, Liang MH, Karlson EW, Cleary PD (1994) Differences between men and women undergoing major orthopedic surgery for degenerative arthritis. Arthr Rheum 37(5):687–694
Lavsky-Shulan M, Wallace RB, Kohout FJ, Lemke JH, Morris MC, Smith IM (1985) Prevalence and functional correlates of low back pain in the elderly: the Iowa 65+ rural health study. J Am Geriatr Soc 3:23–28
Mahoney F, Barthel D (1965) Functional evaluation: Barthel index. Maryland State Med J 14:61–65
McCullen GM, Bernini PM, Bernstein SH, Tosteson TD (1994) Clinical and rentgenographic results of decompression for lumbar spinal stenosis. J Spinal Disord 7:380–387
Mickey RM, Greenland S (1989) The impact on confounder selection criteria on effect estimation. Am J Epidemiol 129:125–137
Mobily PR, Herr KA, Clark MK (1994) An epidemiological analysis of pain in the elderly: the Iowa 65+ study. J Aging Health 6:139–154
Mogil JS, Sternberg WF, Kest B, Pechnick RN, Liebeskind J (1993) Sex differences in the antagonism of swim stress-induced analgesia: effects of gonadectomy and estrogen replacement. Pain 53:17–25
Shabat S, Leitner Y, Nyska M, Berner Y, Fredman B, Gepstein R (2002) Surgical treatment of lumbar spinal stenosis in patients aged 65 years and older. Arch Gerontol Geriatr 35:143–152
Spratt KF, Keller TS, Szpalski M, Vandeputte K, Gunzburg R (2004) A predictive model for outcome after conservative decompression surgery for lumbar spinal stenosis. Eur Spine J 13:14–21
Walker JS, Carmody JJ (1998) Experimental pain in healthy human subject: gender difference in nociception and in response to ibuprofen. Anesth Analg 86:1257–1262
Whiffen JR, Neuwirth MG (1996) Spinal stenosis. In: Bridwell KH, DeWald RL et al. (eds) Textbook of spinal surgery, 2nd edn. Lippincott, Philadelphia
We thank Professor I. Rosenfeld from Dallas, Tex., USA for his statistical assistance and guidance.
About this article
Cite this article
Shabat, S., Folman, Y., Arinzon, Z. et al. Gender differences as an influence on patients’ satisfaction rates in spinal surgery of elderly patients. Eur Spine J 14, 1027–1032 (2005). https://doi.org/10.1007/s00586-004-0808-z