title: Influence of gender on patient-oriented outcomes in spine surgery.
abstract: OBJECTIVE
  Few studies have examined gender differences in patient-oriented health-related quality of life before and after spine surgery. This study examined the influence of gender on baseline status and 1-year postoperative outcomes in a large series of patients undergoing surgery for different degenerative spinal disorders.
  
  
  METHODS
  The study included 1518 patients [812 men and 706 women; mean (SD) age 61.4 ± 16.2 years], with three different pathologies (disc herniation, degenerative spondylolisthesis, or spinal stenosis), treated with specified surgical approaches. Preoperatively and 12 months postoperatively, patients completed the multidimensional Core Outcome Measures Index (COMI). Medical history, surgical details and perioperative complications were documented with the Eurospine "Spine Tango" Surgery 2006 form.
  
  
  RESULTS
  Preoperatively and for all three pathologies, women had significantly (p < 0.05) worse COMI-scores than men, especially for the sub-domains "leg/buttock pain", "dominant pain intensity", and "general quality of life"; the change in the COMI sum score 12 months postoperatively showed no significant gender differences for any pathology (p > 0.05). 71.3 % males and 72.9 % females achieved the minimal clinically important change score (MCIC; 2.2 point reduction) for the COMI. Controlling for potential cofounders (preoperative COMI, ASA, complications, pathology), gender showed no significant association with the failure to achieve MCIC.
  
  
  CONCLUSIONS
  This results show that women do not differ significantly from men regarding their postoperative outcome, even though they present with a worse preoperative status. The management of a patient's condition should not differ depending on their gender, since both men and women are able to improve to a similar extent.
authors.affiliation: Spine Center Division, Department of Research and Development, Schulthess Klinik, Lengghalde 2, 8008, Zurich, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: Pochon
authors.affiliation: Spine Center, Schulthess Klinik, Lengghalde 2, 8008, Zürich, Switzerland.
authors.forename: F S
authors.initials: FS
authors.lastname: Kleinstück
authors.affiliation: Spine Center, Schulthess Klinik, Lengghalde 2, 8008, Zürich, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Porchet
authors.affiliation: Spine Center Division, Department of Research and Development, Schulthess Klinik, Lengghalde 2, 8008, Zurich, Switzerland. anne.mannion@yahoo.com.
authors.forename: Anne F
authors.initials: AF
authors.lastname: Mannion
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D057234:Preoperative Period; D011788:Quality of Life; D012189:Retrospective Studies; D012737:Sex Factors; D013130:Spinal Stenosis / Q000601:surgery*; D013168:Spondylolisthesis / Q000601:surgery*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: COMI; Gender; MCIC; Outcome; Spine surgery