Study Design
This study is a Therapeutic Retrospective Cohort Study
Objective
This study aims to determine if sexual function is relevant for patients with SPS and DS and to determine the impact of operative intervention on sexual function for these patients.
Summary of Background Data
The benefits of non-operative versus operative treatment for patients with spinal stenosis (SPS), and degenerative spondylolisthesis (DS) with regards to sexual function are unknown.
Methods
Demographic, treatment, and follow up data, including the Oswestry Disability Index (ODI), was obtained on patients enrolled in the SPORT study. Based on the response to question #9 in the ODI, patients were classified into a sexual life relevant (SLR) or sexual life not relevant (NR) group. Univariate and Multivariate analysis of patient characteristics comparing the NR and SLR group was performed. Operative treatment groups were compared to the non-operative group with regards to response to ODI question #9 to determine the impact of surgery on sexual function.
Results
1235 patients were included to determine relevance of sex life. 366 patients (29%) were included in the NR group. 869 patients (71%) were included in the SLR group. Patients that were older, female, unmarried, had 3 or more stenotic levels, and had central stenosis were more likely to be in the NR group. 825 patients were included in the analysis comparing operative versus non-operative treatment. At all follow up time points the operative groups had a lower percentage of patients reporting pain with their sex life compared to the non-operative group (p<0.05 at all time points except between >1 level fusion and non-operative at 4 years follow up).
Conclusions
Sex-life is a relevant consideration for the majority of patients with DS and SPS; operative treatment leads to improved sex-life related pain.