title: Gender differences in patients scheduled for lumbar disc herniation surgery: a National Register Study including 15,631 operations.
abstract: OBJECTIVE
  Previous studies have shown gender differences in preoperative status and outcome of spine surgery. This study explores whether gender differences in preoperative demographics exist in patients scheduled for lumbar disc herniation (LDH) surgery.
  
  
  METHODS
  This study includes the preoperative data of the 15,631 patients operated for LDH between years 2000 and 2010, registered in the national Swedish spine register (SweSpine). We analysed preoperative gender differences in age, smoking habits, walking distance, consumption of analgesics, back and leg pain (Visual Analogue Scale; VAS), quality of life (EuroQol; EQ 5D and Short Form-36 Questionnaire; SF-36) and disability (Oswestry Disability Index; ODI).
  
  
  RESULTS
  44 % of the patients were women (mean age 45 ± 13) and 56 % men (mean age 44 ± 13). More women than men were smokers (26 versus 21 %, p < 0.001). Women also reported inferior walking ability (less than 100 metre walking ability 37 vs 30 %; p < 0.001), consumed more analgesics (92 versus 84 %; p < 0.001), reported higher level of pain (mean difference VAS leg 6 (95 % CI 5-7)), had inferior health-related quality of life (mean difference EQ 5D 0.07 (95 % CI 0.05-0.08)) and had higher disability (mean difference ODI 6 (95 % CI 5-6)).
  
  
  CONCLUSIONS
  Women scheduled for LDH surgery report inferior clinical status than men scheduled for the same operation. We have in the literature found no evidence-based data that support such a difference, and the reason for the discrepancy is unclear.
authors.affiliation: Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopaedics, Skane University Hospital, Lund University, SE-205 02, Malmö, Sweden. fredrik.stromqvist@med.lu.se.
authors.forename: Fredrik
authors.identifier: http://orcid.org/0000-0003-3362-6846
authors.initials: F
authors.lastname: Strömqvist
authors.affiliation: Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopaedics, Skane University Hospital, Lund University, SE-205 02, Malmö, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Strömqvist
authors.affiliation: Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopaedics, Skane University Hospital, Lund University, SE-205 02, Malmö, Sweden.
authors.forename: Bo
authors.initials: B
authors.lastname: Jönsson
authors.affiliation: Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopaedics, Skane University Hospital, Lund University, SE-205 02, Malmö, Sweden.
authors.forename: Magnus K
authors.initials: MK
authors.lastname: Karlsson
mesh_terms: D000328:Adult; D017586:Diskectomy; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000453:epidemiology* / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012042:Registries; D017678:Sex Distribution; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
keywords: Demographics; Gender differences; Lumbar disc herniation; PROMs; Surgery