Skip to main content

Advertisement

SpringerLink
Log in

Gender differences in patients scheduled for lumbar disc herniation surgery: a National Register Study including 15,631 operations

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

Previous studies have shown gender differences in preoperative status and outcome of spine surgery. This study explores whether gender differences in preoperative demographics exist in patients scheduled for lumbar disc herniation (LDH) surgery.

Methods

This study includes the preoperative data of the 15,631 patients operated for LDH between years 2000 and 2010, registered in the national Swedish spine register (SweSpine). We analysed preoperative gender differences in age, smoking habits, walking distance, consumption of analgesics, back and leg pain (Visual Analogue Scale; VAS), quality of life (EuroQol; EQ 5D and Short Form-36 Questionnaire; SF-36) and disability (Oswestry Disability Index; ODI).

Results

44 % of the patients were women (mean age 45 ± 13) and 56 % men (mean age 44 ± 13). More women than men were smokers (26 versus 21 %, p < 0.001). Women also reported inferior walking ability (less than 100 metre walking ability 37 vs 30 %; p < 0.001), consumed more analgesics (92 versus 84 %; p < 0.001), reported higher level of pain (mean difference VAS leg 6 (95 % CI 5–7)), had inferior health-related quality of life (mean difference EQ 5D 0.07 (95 % CI 0.05–0.08)) and had higher disability (mean difference ODI 6 (95 % CI 5–6)).

Conclusions

Women scheduled for LDH surgery report inferior clinical status than men scheduled for the same operation. We have in the literature found no evidence-based data that support such a difference, and the reason for the discrepancy is unclear.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Stromqvist B, Fritzell P, Hagg O, Jonsson B, Sanden B, Swedish Society of Spinal S (2013) Swespine: the Swedish spine register: the 2012 report. Eur Spine J 22:953–974. doi:10.1007/s00586-013-2758-9

    Article  PubMed  PubMed Central  Google Scholar 

  2. van Tulder MW, Koes BW, Bouter LM (1995) A cost-of-illness study of back pain in The Netherlands. Pain 62:233–240

    Article  PubMed  Google Scholar 

  3. Stromqvist F, Ahmad M, Hildingsson C, Jonsson B, Stromqvist B (2008) Gender differences in lumbar disc herniation surgery. Acta orthopaedica 79:643–649. doi:10.1080/17453670810016669

    Article  PubMed  Google Scholar 

  4. Peul WC, Brand R, Thomeer RT, Koes BW (2008) Influence of gender and other prognostic factors on outcome of sciatica. Pain 138:180–191. doi:10.1016/j.pain.2007.12.014

    Article  PubMed  Google Scholar 

  5. Stromqvist B (2002) Evidence-based lumbar spine surgery. The role of national registration. Acta Orthop Scand Suppl 73:34–39

    Article  PubMed  Google Scholar 

  6. Stromqvist B, Fritzell P, Hagg O, Jonsson B (2005) One-year report from the Swedish National Spine Register. Swedish Society of Spinal Surgeons. Acta Orthop Suppl 76:1–24. doi:10.1080/17453690510041950

    Article  PubMed  Google Scholar 

  7. Stromqvist B, Fritzell P, Hagg O, Jonsson B, Swedish Society of Spinal S (2009) The Swedish Spine Register: development, design and utility. Eur Spine J 18 Suppl(3):294–304. doi:10.1007/s00586-009-1043-4

    Article  Google Scholar 

  8. Peul WC, van Houwelingen HC, van den Hout WB, Brand R, Eekhof JA, Tans JT, Thomeer RT, Koes BW, Leiden-The Hague Spine Intervention Prognostic Study G (2007) Surgery versus prolonged conservative treatment for sciatica. N Engl J Med 356:2245–2256. doi:10.1056/NEJMoa064039

    Article  PubMed  CAS  Google Scholar 

  9. Weinstein JN, Tosteson TD, Lurie JD, Tosteson AN, Hanscom B, Skinner JS, Abdu WA, Hilibrand AS, Boden SD, Deyo RA (2006) Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT): a randomized trial. JAMA 296:2441–2450. doi:10.1001/jama.296.20.2441

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  10. Spangfort EV (1972) The lumbar disc herniation. A computer-aided analysis of 2,504 operations. Acta Orthop Scand Suppl 142:1–95

    Article  PubMed  CAS  Google Scholar 

  11. Shimia M, Babaei-Ghazani A, Sadat BE, Habibi B, Habibzadeh A (2013) Risk factors of recurrent lumbar disk herniation. Asian J Neurosurg 8:93–96. doi:10.4103/1793-5482.116384

    Article  PubMed  PubMed Central  Google Scholar 

  12. Miwa S, Yokogawa A, Kobayashi T, Nishimura T, Igarashi K, Inatani H, Tsuchiya H (2013) Risk factors of recurrent lumbar disc herniation: a single center study and review of the literature. J Spinal Disord Tech. doi:10.1097/BSD.0b013e31828215b3

    PubMed  Google Scholar 

  13. An HS, Silveri CP, Simpson JM, File P, Simmons C, Simeone FA, Balderston RA (1994) Comparison of smoking habits between patients with surgically confirmed herniated lumbar and cervical disc disease and controls. J Spinal Disord 7:369–373

    PubMed  CAS  Google Scholar 

  14. Kelsey JL, Githens PB, O’Conner T, Weil U, Calogero JA, Holford TR, White AA 3rd, Walter SD, Ostfeld AM, Southwick WO (1984) Acute prolapsed lumbar intervertebral disc. An epidemiologic study with special reference to driving automobiles and cigarette smoking. Spine 9:608–613

    Article  PubMed  CAS  Google Scholar 

  15. OECD (2013) Health at a Glance 2013 OECD Indicators. 54–55. doi:10.1787/health_glance-2013-en

  16. Giantomaso T, Makowsky L, Ashworth NL, Sankaran R (2003) The validity of patient and physician estimates of walking distance. Clin Rehabil 17:394–401

    Article  PubMed  Google Scholar 

  17. Okoro T, Qureshi A, Sell B, Sell P (2010) The accuracy of assessment of walking distance in the elective spinal outpatients setting. Eur Spine J 19:279–282. doi:10.1007/s00586-009-1152-0

    Article  PubMed  PubMed Central  Google Scholar 

  18. Initiative USBaJ (2011) The burden of musculoskeletal diseases in the United States, 2nd ed

  19. Sullivan MK, J, Ware J (1994) SF-36 hälsoenkät : svensk manual och tolkningsguide. Book 10:29–31

  20. Fairbank JC, Couper J, Davies JB, O’Brien JP (1980) The oswestry low back pain disability questionnaire. Physiotherapy 66:271–273

    PubMed  CAS  Google Scholar 

  21. Kim HJ, Suh BG, Lee DB, Park JY, Kang KT, Chang BS, Lee CK, Yeom JS (2013) Gender difference of symptom severity in lumbar spinal stenosis: role of pain sensitivity. Pain physician 16:E715–E723

    PubMed  Google Scholar 

  22. Kim HJ, Cho CH, Kang KT, Chang BS, Lee CK, Yeom JS (2015) The significance of pain catastrophizing in clinical manifestations of patients with lumbar spinal stenosis: mediation analysis with bootstrapping. Spine J 15:238–246. doi:10.1016/j.spinee.2014.09.002

    Article  PubMed  Google Scholar 

  23. Hawker GA, Wright JG, Coyte PC, Williams JI, Harvey B, Glazier R, Badley EM (2000) Differences between men and women in the rate of use of hip and knee arthroplasty. N Engl J Med 342:1016–1022. doi:10.1056/NEJM200004063421405

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

We have no potential conflict of interest.

Author information

Authors and Affiliations

  1. Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopaedics, Skane University Hospital, Lund University, SE-205 02, Malmö, Sweden

    Fredrik Strömqvist, Björn Strömqvist, Bo Jönsson & Magnus K. Karlsson

Authors
  1. Fredrik Strömqvist
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Björn Strömqvist
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bo Jönsson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Magnus K. Karlsson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fredrik Strömqvist.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Strömqvist, F., Strömqvist, B., Jönsson, B. et al. Gender differences in patients scheduled for lumbar disc herniation surgery: a National Register Study including 15,631 operations. Eur Spine J 25, 162–167 (2016). https://doi.org/10.1007/s00586-015-4052-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-015-4052-5

Keywords

Search

Navigation