title: Gender differences after lumbar sequestrectomy: a prospective clinical trial using quantitative sensory testing.
abstract: Quantitative sensory testing (QST) gained popularity to evaluate the time course of recovery in sensory dysfunction and the results of different treatment options. Concerning sex differences in lumbar spine surgery, female gender seems to play a major role as a negative prognostic factor in different spinal disorders. For this purpose, we hypothesised that there are also comparable differences in pain patterns in men and women after lumbar sequestrectomy using QST.
  
  
  
  We applied the QST protocol of the German Research Network on Neuropathic Pain in 53 patients (21 women and 32 men) with a single lumbar disc herniation confirmed on MRI treated by a lumbar sequestrectomy. Further evaluation included a detailed medical history, a physical examination, and various questionnaires: Beck-Depression-Inventory, Oswestry Disability Index, Core Outcome Measure Index, painDETECT-Questionnaire and EQ-5D thermometer.
  
  
  
  Our analyses showed lower heat thresholds in females preoperatively, that adjusted to that of males 1 week postoperatively. Pressure pain thresholds were lower in women as well, but differed between genders throughout the study. Vibration perception deficits resolve earlier in female than in male patients. Both, women and men, had an excellent overall improvement, postoperatively.
  
  
  
  Our results clearly revealed pre- and postoperative differences in pain perception between genders. These differences have to be taken into account in the evaluation of outcome between genders. Therefore, QST seems to be a good method to evaluate the time course of recovery after surgery.
authors.affiliation: Departmen of Neurosurgery, Innsbruck Medical University, Anichstr. 35, 6020, Innsbruck, Austria. anja.tschugg@i-med.ac.at.
authors.forename: Anja
authors.initials: A
authors.lastname: Tschugg
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Wolfgang N
authors.initials: WN
authors.lastname: Löscher
authors.affiliation: Departmen of Neurosurgery, Innsbruck Medical University, Anichstr. 35, 6020, Innsbruck, Austria.
authors.forename: Sara
authors.initials: S
authors.lastname: Lener
authors.affiliation: Department of Neuroradiology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Wildauer
authors.affiliation: Departmen of Neurosurgery, Innsbruck Medical University, Anichstr. 35, 6020, Innsbruck, Austria.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Hartmann
authors.affiliation: Department of Medical Statistics and Health Economics, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Neururer
authors.affiliation: Departmen of Neurosurgery, Innsbruck Medical University, Anichstr. 35, 6020, Innsbruck, Austria.
authors.forename: Claudius
authors.initials: C
authors.lastname: Thomé
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D058748:Pain Perception / Q000502:physiology; D017288:Pain Threshold; D011312:Pressure; D011379:Prognosis; D011446:Prospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires; D055698:Touch Perception / Q000502:physiology; D016896:Treatment Outcome; D014732:Vibration
keywords: Gender differences in spine surgery; Lumbar disc herniation; Lumbar radiculopathy; Lumbar sequestrectomy; Quantitative sensory testing