Sex Life and Impact of Operative Intervention on Sex Life-related Pain in Degenerative Spinal Conditions: An Analysis of the SPORT Study

Study Design. This study is a therapeutic retrospective cohort study Objectives. This study aims to determine whether sexual function is relevant for patients with spinal stenosis (SPS) and degenerative spondylolisthesis (DS) and to determine the impact of operative inter vqAvention on sexual function for these patients. Summary of Background Data. The benefits of nonoperative versus operative treatment for patients with SPS and DS with regards to sexual function are unknown. Methods. Demographic, treatment, and follow-up data, including the Oswestry Disability Index (ODI), were obtained on patients enrolled in the SPORT study. Based on the response to question #9 in the ODI, patients were classified into a sexual life relevant (SLR) or sexual life not relevant (NR) group. Univariate and multivariate analysis of patient characteristics comparing the NR and SLR group were performed. Operative treatment groups were compared to the nonoperative group with regards to response to ODI question #9 to determine the impact of surgery on sexual function. Results. A total of 1235 patients were included to determine relevance of sex life. Three hundred sixty-six patients (29%) were included in the NR group. Eight hundred sixty-nine patients (71%) were included in the SLR group. Patients that were older, female, unmarried, had three or more stenotic levels, and had central stenosis were more likely to be in the NR group. Eight hundred twenty-five patients were included in the analysis comparing operative versus nonoperative treatment. At all follow-up time points, the operative groups had a lower percentage of patients reporting pain with their sex life compared to the nonoperative group (P < 0.05 at all time points except between more than one level fusion and nonoperative at 4 years’ follow-up). Conclusion. Sex life is a relevant consideration for the majority of patients with DS and SPS; operative treatment leads to improved sex life-related pain. Level of Evidence: 3

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