Sex-Dependent Differences in Symptom-Related Disability Due to Lumbar Spinal Stenosis
Received 1 December 2020
Accepted for publication 6 January 2021
Published 16 March 2021 Volume 2021:14 Pages 747—755
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Michael Schatman
Raffael Peteler,1,2 Paul Schmitz,2 Martin Loher,2 Petra Jansen,3 Joachim Grifka,1 Achim Benditz1
1Department of Orthopedics, University Medical Center Regensburg, Asklepios Klinikum Bad Abbach, Bad Abbach, Bavaria, Germany; 2Department of Trauma Surgery, Caritas-Krankenhaus St. Josef, Regensburg, Bavaria, Germany; 3Department of Sport Science, University of Regensburg, Regensburg, Bavaria, Germany
Correspondence: Achim Benditz Kaiser-Karl-V.-Allee 3, Bad Abbach, 93077, Germany
Email [email protected]
Study Design: Retrospective observational study.
Objective: The objective of this study is to identify possible sex-dependent differences in symptom-related disability in patients with lumbar spinal stenosis.
Methods: 103 consecutive outpatients (42 men and 61 women) with lumbar spinal stenosis were assessed on the basis of their medical history, the physical examination, and a series of questionnaires including the Oswestry Disability Index (ODI), the Roland Morris Disability Questionnaire (RMDQ), the Patient Health Questionnaire module 9 (PHQ-9), and the Depression Anxiety Stress Scales (DASS). Narrowing of the spinal canal was graded according to the method established by Schizas. Parameters were statistically analyzed according to the biological sex of the patients. The influence of the variables on the disability scores was analyzed by means of a multivariate regression model.
Results: Symptom severity was equally distributed between men and women. Female patients showed higher RMDQ and ODI scores as well as significantly higher intermediate depression scores. The confounding variables age, pain chronicity, and psychological affection as well as the symptoms level of pain and paresis were dependent on patient sex.
Conclusion: The study shows sex-depended differences in the perception of symptoms of lumbar spinal stenosis and disability of life. The findings suggest that the main mediators are pain perception and psychological influences on the quality of life.
Keywords: LSS, quality of life, disability, sex differences, pain