The article examines the differences in imaging and clinical characteristics between women and men with lumbar degenerative spondylolisthesis and their association with fusion surgery. The study analyzed preoperative radiographs, CT scans, and intraoperative fluoroscopic images of 380 patients, with symptoms and comorbidity obtained from patient records. The results revealed that women had greater translation, listhesis angle, lordosis, and pelvic incidence, as well as less diastasis and disc height. Women also had a higher rate of fusion compared to men. The final multivariable models showed that comorbidity, diastasis, and anterior disc height were associated with fusion in women, while opioid use, translation, and diastasis were associated with fusion in men. The findings suggest that the decision for fusion was based on a combination of clinical and imaging characteristics that varied between men and women
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best rated spine facility in UK
Published article
CONCLUSIONS: There were differences in imaging characteristics between men and women, and women were more likely to undergo fusion. Differences in fusion within groups indicate that decisions for fusion were based on composite assessments of clinical and imaging characteristics that varied between men and women.
Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
Eur Spine J. 2023 Oct 5. doi: 10.1007/s00586-023-07958-0. Online ahead of print.ABSTRACTPURPOSE: The goals were to ascertain if differences in imaging/clinical characteristics between women and men were associated with differences in fusion for lumbar degenerative spondylolisthesis.METHODS: Patients had preoperative standing radiographs, CT scans, and intraoperative fluoroscopic images. Symptoms and comorbidity were obtained from patients; procedure,
Eur Spine J. 2023 Oct 5. doi: 10.1007/s00586-023-07958-0. Online ahead of print.
ABSTRACT
PURPOSE: The goals were to ascertain if differences in imaging/clinical characteristics between women and men were associated with differences in fusion for lumbar degenerative spondylolisthesis.
METHODS: Patients had preoperative standing radiographs, CT scans, and intraoperative fluoroscopic images. Symptoms and comorbidity were obtained from patients; procedure (fusion-surgery or decompression-alone) was obtained from intraoperative records. With fusion surgery as the dependent variable, men and women were compared in multivariable logistic regression models with clinical/imaging characteristics as independent variables. The sample was dichotomized, and analyses were repeated with separate models for men and women.
RESULTS: For 380 patients (mean age 67, 61% women), women had greater translation, listhesis angle, lordosis, and pelvic incidence, and less diastasis and disc height (all p ≤ 0.03). The rate of fusion was higher for women (78% vs. 65%; OR 1.9, p = 0.008). Clinical/imaging variables were associated with fusion in separate models for men and women. Among women, in the final multivariable model, less comorbidity (OR 0.5, p = 0.05), greater diastasis (OR 1.6, p = 0.03), and less anterior disc height (OR 0.8, p = 0.0007) were associated with fusion. Among men, in the final multivariable model, opioid use (OR 4.1, p = 0.02), greater translation (OR 1.4, p = 0.0003), and greater diastasis (OR 2.4, p = 0.0002) were associated with fusion.
CONCLUSIONS: There were differences in imaging characteristics between men and women, and women were more likely to undergo fusion. Differences in fusion within groups indicate that decisions for fusion were based on composite assessments of clinical and imaging characteristics that varied between men and women.
PMID:37796286 | DOI:10.1007/s00586-023-07958-0
The London Spine Unit : best rated spine facility in UK
Read the original publication:
Differences in imaging and clinical characteristics are associated with higher rates of decompression-fusion versus decompression-alone in women compared to men for lumbar degenerative spondylolisthesis
