Sexual dimorphism in degenerative disorders of the spine.

Sexual dimorphism is evident during formation, growth, and development of the spine. Pregnancy alters spine physiology and is a risk factor for back pain. The processes of aging and spinal degeneration adversely affect men and women slightly differently. Although degenerative changes are observed at similar rates in both sexes, women seem to be more susceptible to degenerative changes leading to instability and malalignment, structural deterioration, such a stenosis or disc degeneration. Surgical satisfaction is greater in men, which has been attributed to poorer preoperative function secondary to more advanced disease at time of surgery and lower patient expectations for clinical improvement, both observed in women.