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Sexual Dysfunction: Prevalence and Prognosis in Patients Operated for Degenerative Lumbar Spondylolisthesis.

Authors
  • Chan, Andrew K1
  • Bisson, Erica F2
  • Fu, Kai-Ming3
  • Park, Paul4
  • Robinson, Leslie C1
  • Bydon, Mohamad5
  • Glassman, Steven D6
  • Foley, Kevin T7, 8
  • Shaffrey, Christopher I9
  • Potts, Eric A10, 11
  • Shaffrey, Mark E12
  • Coric, Domagoj13
  • Knightly, John J14
  • Wang, Michael Y15
  • Slotkin, Jonathan R16
  • Asher, Anthony L13
  • Virk, Michael S3
  • Kerezoudis, Panagiotis5
  • Alvi, Mohammed A5
  • Guan, Jian2
  • And 2 more
  • 1 Department of Neurological Surgery, University of California, San Francisco, San Francisco, California.
  • 2 Department of Neurological Surgery, University of Utah, Salt Lake City, Utah.
  • 3 Department of Neurological Surgery, Weill Cornell Medical Center, New York, New York.
  • 4 Department of Neurological Surgery, University of Michigan, Ann Arbor, Michigan.
  • 5 Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota.
  • 6 Norton Leatherman Spine Center, Louisville, Kentucky.
  • 7 Department of Neurological Surgery, University of Tennessee, Knoxville, Tennessee.
  • 8 Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee.
  • 9 Departments of Neurological Surgery and Orthopedic Surgery, Duke University; Durham, North Carolina.
  • 10 Department of Neurological Surgery, Indiana University, Bloomington, Indiana. , (India)
  • 11 Goodman Campbell Brain and Spine, Indianapolis, Indiana. , (India)
  • 12 Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia.
  • 13 Neuroscience Institute, Carolina Neurosurgery and Spine Associates, Carolinas HealthCare System, Charlotte, North Carolina.
  • 14 Atlantic Neurosurgical Specialists, Morristown, New Jersey. , (Jersey)
  • 15 Department of Neurological Surgery, University of Miami, Miami, Florida.
  • 16 Geisinger Health, Danville, Pennsylvania.
  • 17 Atlanta Brain and Spine Care, Atlanta, Georgia. , (Georgia)
Type
Published Article
Journal
Neurosurgery
Publication Date
Aug 01, 2020
Volume
87
Issue
2
Pages
200–210
Identifiers
DOI: 10.1093/neuros/nyz406
PMID: 31625568
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

There is a paucity of investigation on the impact of spondylolisthesis surgery on back pain-related sexual inactivity. To investigate predictors of improved sex life postoperatively by utilizing the prospective Quality Outcomes Database (QOD) registry. A total of 218 patients who underwent surgery for grade 1 degenerative lumbar spondylolisthesis were included who were sexually active. Sex life was assessed by Oswestry Disability Index item 8 at baseline and 24-mo follow-up. Mean age was 58.0 ± 11.0 yr, and 108 (49.5%) patients were women. At baseline, 178 patients (81.7%) had sex life impairment. At 24 mo, 130 patients (73.0% of the 178 impaired) had an improved sex life. Those with improved sex lives noted higher satisfaction with surgery (84.5% vs 64.6% would undergo surgery again, P = .002). In multivariate analyses, lower body mass index (BMI) was associated with improved sex life (OR = 1.14; 95% CI [1.05-1.20]; P < .001). In the younger patients (age < 57 yr), lower BMI remained the sole significant predictor of improvement (OR = 1.12; 95% CI [1.03-1.23]; P = .01). In the older patients (age ≥ 57 yr)-in addition to lower BMI (OR = 1.12; 95% CI [1.02-1.27]; P = .02)-lower American Society of Anesthesiologists (ASA) grades (1 or 2) (OR = 3.7; 95% CI [1.2-12.0]; P = .02) and ≥4 yr of college education (OR = 3.9; 95% CI [1.2-15.1]; P = .03) were predictive of improvement. Over 80% of patients who present for surgery for degenerative lumbar spondylolisthesis report a negative effect of the disease on sex life. However, most patients (73%) report improvement postoperatively. Sex life improvement was associated with greater satisfaction with surgery. Lower BMI was predictive of improved sex life. In older patients-in addition to lower BMI-lower ASA grade and higher education were predictive of improvement. Copyright © 2019 by the Congress of Neurological Surgeons.

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