On SAGE Insight:  Influence of Gender on Health-Related Quality of Life and Disability After Surgery

Article title: Influence of Gender on Health-Related Quality of Life and Disability at 1 Year After Surgery for Thoracolumbar Burst Fractures

From Global Spine Journal

The aim of this study of self-reported outcomes of surgery, was to investigate how gender influences health-related quality of life (HRQOL) and disability in patients operated on for Thoracolumbar burst fractures (TLBF). Defining success of any therapy in spinal pathology must assess the patient’s view of the treatment. It has been shown extensively that outcome of any medical procedure cannot rely only on objective measures, as patients may have different opinions from those of their physicians.  Moreover, until now, no functional or radiological parameter has been linked to the quality of life and subjective outcome after spinal procedures, including those for TLBF.

In the study, male patients reported better outcomes at 1 year after surgery for TLBF than women. This was true in all domains of disability and HRQOL. Disability strongly correlated with both physical and mental components of quality of life in women, but to a lesser extent in men. The pain was closely associated with quality of life in women, but not in men. The paper found gender-related differences favoring men after surgical interventions for spinal fractures.

Abstract

Study Design:
Case series.

Objective:
Thoracolumbar burst fractures (TLBF) are the most frequent type of spinal fractures. Approximately half of the patients are neurologically intact and their treatment is still debatable. Gender could influence outcome after surgical procedures, but this is still unclear in patients sustaining a spinal fracture. The aim of this study was to investigate how gender influences health-related quality of life (HRQOL) and disability in patients operated on for TLBF.

Methods:
We identified 44 neurologically intact patients from a consecutive series of patients treated surgically for a single-level traumatic burst fracture (AOSpine Subaxial Classification System A3) in the thoracolumbar transition area (Th12-L2). At 1 year after surgery, they were evaluated using the SF-36v2 questionnaire to assess HRQOL and Oswestry Disability Index (ODI) questionnaire to evaluate disability.

Results:
Male patients scored higher in each item of the SF-36v2, with significant differences (P < .05) for Physical Function (PF), Bodily Pain (BP), and Social Function (SF). Male patients also had lower disability scores. Overall ODI score had a strong correlation with Physical Function, Role-Physical, Bodily Pain, Vitality, Mental Health, and overall Physical Component Summary (PCS) of the SF-36 in women, but only with Physical Function, Role-Physical, Role-Emotional, and PCS in men.

Conclusions:
In this study, male patients reported better outcomes at 1 year after surgery for TLBF than women. Disability strongly correlated with the overall HRQOL, physical and mental health in women, but not in men. We found gender-related differences favoring men after surgical interventions for spinal fractures.

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Article details
Influence of Gender on Health-Related Quality of Life and Disability at 1 Year After Surgery for Thoracolumbar Burst Fractures
Tiberiu Maior, MD,*, Gheorghe Ungureanu, MD*, Cristian Kakucs, MD, Cristian Berce, PhD, Bobe Petrushev, MD, and Ioan-Stefan Florian.
First Published July 7, 2017
DOI: 10.1177/2192568217710854
From Global Spine Journal

 

 

 

     
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