Lim Winston Shang Rong, Liow Ming Han Lincoln, Goh Graham S., Yeo William, Ling Zhixing Marcus, Yue Wai-Mun, Guo Chang Ming, Tan Seang Beng
Department of Orthopedic Surgery, Singapore General Hospital, Singapore.
The Orthopaedic Centre, Mount Elizabeth Medical Centre, Singapore.
Int J Spine Surg. 2020 Oct;14(5):756-761. doi: 10.14444/7108. Epub 2020 Oct 12.
Women undergoing lumbar spine surgery report greater preoperative pain and disability and have less improvement after surgery. There is a paucity of literature on sex-related differences after minimally invasive surgery transforaminal lumbar interbody fusion (MIS TLIF) surgery. We aim to determine whether sex influences outcome after MIS TLIF at 5-year midterm follow-up.
Prospectively collected registry data for 907 patients who underwent MIS TLIF at a single institution from 2004 to 2013 were reviewed. Of these, 296 patients (94 males and 202 females) were reviewed at 5-year follow-up. All patients were assessed preoperatively and postoperatively at 2 and 5 years. Data recorded included patient demographics, Oswestry Disability Index (ODI), Short-Form 36 Physical and Mental component scores (SF-36 PCS and MCS), and the North American Spine Society lumbar spine outcome assessment instrument.
Females who underwent MIS TLIF were generally younger (females, 52.2 years; males, 56.1 years; = .04). Females had significantly poorer preoperative ODI (females, 49.5; males, 41.5; < .001) and SF-36 PCS (females, 31.9; males, 35.6; < .01) and MCS (females, 44.9; males, 49.2; < .01) scores. At 2-year and 5-year follow-up, there were no significant differences in ODI, SF-36, and pain scores between sexes. Both groups reported similar proportions that returned to work and returned to function. There were no differences in proportion of patients who were satisfied or had their expectations fulfilled.
Women who undergo MIS TLIF have poorer preoperative function and quality of life than men. However, women demonstrated greater improvement after surgery, attaining similar clinical outcomes at 5-year follow-up.
接受腰椎手术的女性术前疼痛和残疾程度更高，术后改善程度更小。关于微创经椎间孔腰椎椎体间融合术（MIS TLIF）后性别差异的文献较少。我们旨在确定在5年中期随访时性别是否会影响MIS TLIF的手术效果。
回顾性分析了2004年至2013年在单一机构接受MIS TLIF手术的907例患者的前瞻性收集的登记数据。其中，296例患者（94例男性和202例女性）在5年随访时接受了评估。所有患者在术前以及术后2年和5年进行了评估。记录的数据包括患者人口统计学资料、Oswestry功能障碍指数（ODI）、简短健康调查问卷36项生理和心理成分评分（SF-36 PCS和MCS）以及北美脊柱协会腰椎手术效果评估工具。
接受MIS TLIF手术的女性通常更年轻（女性52.2岁，男性56.1岁；P = 0.04）。女性术前ODI（女性49.5，男性41.5；P < 0.001）、SF-36 PCS（女性31.9，男性35.6；P < 0.01）和MCS（女性44.9，男性49.2；P < 0.01）评分明显更差。在2年和5年随访时，性别之间的ODI、SF-36和疼痛评分没有显著差异。两组报告的恢复工作和恢复功能的比例相似。患者满意度或期望达成比例没有差异。
接受MIS TLIF手术的女性术前功能和生活质量比男性差。然而，女性术后改善更大，在5年随访时获得了相似的临床结果。
3级。
