Sexual function after cervical spine surgery: Independent predictors of functional impairment.
Sexual function (SF) is an important component of patient-focused health related quality of life (HRQoL), but it has not been well studied in spine surgery. This study aims to assess SF after cervical spine surgery and identify predictors of SF. This single-center retrospective study evaluates SF of adults who underwent cervical spine surgery 2007-2012. Predictor variables included demographics, medical/surgical history, operative information, HRQoL measures (Neck Disability Index, SF-12), validated SF surveys [Female Sexual Function Index (FSFI) and Brief Sexual Function Inventory (BSFI) for males], and a study-specific SF questionnaire. 59 patients (31M, 28F; mean age=56±8.4) had significantly lower SF scores compared to age-matched peers: average BSFI = 2.26±1.22 (vs. 06±0.74), average FSFI=13.05±11.42 (<26.55 indicating sexual dysfunction). In men, lower mental SF-12 and higher NDI, back pain, and number of operated levels were associated with lower BSFI scores (all p<0.05). In women, higher total number of medications and pain medications were associated with lower FSFI scores (both p<0.05). 46% of patients reported difficulty performing a sexual position after surgery that they had previously enjoyed. 39% of men had difficulty on top during intercourse, and 32% of participants reported difficulty performing oral sex. 39% of patients reported worse SF, while only 5% reported an improvement in postoperative SF. Men and women who underwent cervical spine surgery had lower SF scores than age-matched peers, likely attributable to general mental health, regional neck disability, back pain, and medications. A large portion of patients reported subjectively worsened SF after surgery.
Department of Orthopedic Surgery, University of California, 500 Parnassus Avenue, MU-320W, San Francisco, CA 94143, USA; Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue, Rm 779M, CA 94143, USA. Electronic address: malla.keefe@ucsf.edu.
Malla K
MK
Keefe
Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue, Rm 779M, CA 94143, USA. Electronic address: corinna.zygourakis@ucsf.edu.
Corinna C
CC
Zygourakis
Department of Orthopedic Surgery, University of California, 500 Parnassus Avenue, MU-320W, San Francisco, CA 94143, USA. Electronic address: alekos.theologis@ucsf.edu.
Alexander A
AA
Theologis
Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue, Rm 779M, CA 94143, USA. Electronic address: emma.canepa@ucsf.edu.
Emma
E
Canepa
Department of Orthopedic Surgery, University of California, 500 Parnassus Avenue, MU-320W, San Francisco, CA 94143, USA. Electronic address: jeremy.shaw@ucsf.edu.
Jeremy D
JD
Shaw
Department of Orthopedic Surgery, University of California, 500 Parnassus Avenue, MU-320W, San Francisco, CA 94143, USA; Department of Radiology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA. Electronic address: lauren.a.hackney@gmail.com.
Lauren H
LH
Goldman
Department of Orthopedic Surgery, University of California, 500 Parnassus Avenue, MU-320W, San Francisco, CA 94143, USA. Electronic address: shane.burch@ucsf.edu.
Shane
S
Burch
Department of Orthopedic Surgery, University of California, 500 Parnassus Avenue, MU-320W, San Francisco, CA 94143, USA. Electronic address: sigurd.berven@ucsf.edu.
Sigurd
S
Berven
Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue, Rm 779M, CA 94143, USA. Electronic address: dean.chou@ucsf.edu.
Dean
D
Chou
Department of Orthopedic Surgery, University of California, 500 Parnassus Avenue, MU-320W, San Francisco, CA 94143, USA. Electronic address: tayb@ucsf.edu.
Bobby
B
Tay
Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue, Rm 779M, CA 94143, USA. Electronic address: praveen.mummaneni@ucsf.edu.
Praveen
P
Mummaneni
Department of Orthopedic Surgery, University of California, 500 Parnassus Avenue, MU-320W, San Francisco, CA 94143, USA. Electronic address: vedat.deviren@ucsf.edu.
Vedat
V
Deviren
Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue, Rm 779M, CA 94143, USA. Electronic address: christopher.ames@ucsf.edu.
Christopher P
CP
Ames
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000209:etiology*; D013123:Spinal Fusion / Q000009:adverse effects*
Cervical spine surgery; Sexual function; Surgical treatment