Spinal surgery diminishes low back pain and improves sexual function

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New research presented at the 2015 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) (24–28 March, Las Vegas, USA), found that 70% of chronic low back pain patients consider sexual activity relevant to their life quality, and patients who receive surgical treatment for spinal spondylolisthesis and spinal stenosis were twice as likely to report no pain during sex.

“Our current research sheds light on the effect that spinal surgery has on a patient’s sex life and begins to describe the impact spinal disease has on this very important aspect of life,” said senior study author Shane Burch, an orthopaedic surgeon at the University of California, San Francisco, USA.

Researchers reviewed data from the Spine Patients Outcomes Research Trial (SPORT) of 1,235 patients diagnosed with spondylolisthesis or stenosis. Patient responses to the question, “In the past week, how has pain affected your sex life?” were used to determine sex-life relevance. Patients selecting the options, “unable to answer” or “does not apply to me,” were placed in the sex life non-relevant group. Patients selecting other options were placed into the sex life relevant group. The mean ages of patients in the sex life non-relevant and sex life relevant groups were 68 and 63 years, respectively. Seventy per cent of patients were in the sex-life relevant group.

There was a higher association of being in the sex life non-relevant group for patients who were female or unmarried, or had a coexisting joint problem or hypertension. At baseline, 40% of sex life relevant patients reported having some level of pain related to sex.

The study included 825 patients, 449 with stenosis and 376 with spondylolisthesis. A total of 294 patients received nonoperative treatment and 531 received surgical treatment. Non-operative patients were more likely to report pain related to sex at all follow-up time frames (from 41% compared to 20%). The percentages remained constant during annual visits at one year, two years, three years and four years after surgery. Prior studies found that 41% of physicians routinely question patients with lumbar disc herniation about sexual problems.

“Our current research has two important findings,” said Horst. “The first is that sexual activity and sexual function is an important consideration for patients with degenerative spine conditions. The study also shows that sexual function is a more relevant consideration for patients who are married, younger, and male. The second important finding of our study is that patients with degenerative conditions of the spine treated with surgery reported less pain with their sex life compared to patients treated without surgery. This finding lasted throughout the four years of follow-up.”

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