Sexual Dysfunction Secondary to Lumbar Stiffness in Adult Spinal Deformity Patients before and after Long-Segment Spinal Fusion.
Abstract
OBJECT:Sexual function is an important factor which contributes to quality of life.
ASD patients may have sexual limitations due to lumbar spinal stiffness which may
be affected by long-segment fusion. METHODS:This study utilized a multi-center, prospectively
defined, consecutive cohort of ASD patients. The primary outcome in this study was
the LSDI question 10: "Choose the statement that best describes the effect of low
back stiffness on your ability to engage in sexual intercourse". RESULTS:In total,
368 patients were included in this study, including 76 males and 292 females of which
80.7% (n=293) underwent 9 or more level fusion and 74.4% (n=270) had pelvic fixation.
Baseline LSDI sexual function scores averaged 1.7 (SD 1.3), which improved to 1.3
(SD 1.2) at 2-year follow-up (p = 0.0008). After adjusting for confounding factors,
worse LSDI sexual function score was strongly associated with worse ODI, SRS total,
and SF-36 PCS and MCS scores at both baseline and 2-year follow-up (p<0.05 for all
comparisons). Predictors of poorer baseline sexual function included older age, increased
SVA, and increased back pain (p<0.05 for all comparisons). Predictors of improvement
in sexual function at 2-year follow-up included SVA improvement (p=0.0032) and decreased
postoperative back pain (p<0.0001). CONCLUSIONS:This study found that sexual dysfunction
scores due to lumbar stiffness significantly improved following surgery for ASD. Additionally,
lumbar stiffness related sexual dysfunction is strongly related to overall outcome
measured by ODI and SRS total score, highlighting the importance of sexual health
on overall outcome in ASD patients.
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https://hdl.handle.net/10161/20577Published Version (Please cite this version)
10.1016/j.wneu.2020.04.033Publication Info
Daniels, Alan H; Reid, Daniel; Durand, Wesley; Disilvestro, Kevin; Hamilton, David
K; Passias, Peter; ... International Spine Study Group (2020). Sexual Dysfunction Secondary to Lumbar Stiffness in Adult Spinal Deformity Patients
before and after Long-Segment Spinal Fusion. World neurosurgery. 10.1016/j.wneu.2020.04.033. Retrieved from https://hdl.handle.net/10161/20577.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Christopher Ignatius Shaffrey
Professor of Orthopaedic Surgery

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