Affiliation:
1. Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Sungnam, Korea
Abstract
Background: Given that there are gender differences in pain perception, it is likely that
there are differences in pain responses between men and women with lumbar spinal stenosis
(LSS). Furthermore, these differences may lead to different degrees of impairment in both daily
activities and quality of life between men and women.
Objective: To elucidate the difference of LSS symptom severity between genders in relation
to pain sensitivity.
Study Design: Retrospective analysis of prospectively collected data.
Methods: A total of 160 patients who had symptomatic degenerative lumbar spinal stenosis
completed a series of questionnaires on their first visit in the outpatient clinic, including a
pain sensitivity questionnaire (PSQ) (total PSQ and PSQ-minor), Oswestry Disability Index (ODI),
visual analog scale (VAS) for back pain, and Short Form-36 (SF-36). Using magnetic resonance
images, the degree of canal stenosis and disc degeneration were graded based on the method
by Schizas and the Pfirrmann classification, respectively. Symptom severity, pain sensitivity, and
radiologic findings were compared between men and women. In each gender group analysis,
the correlation between pain sensitivity and symptom severity was analyzed.
Results: After adjustment for age and the grade of disc degeneration, the pain sensitivity
represented by total PSQ and PSQ-minor was significantly higher in women than in men.
Moreover, there was a higher VAS for back pain/leg pain and ODI in women compared to men
after adjustment for body mass index (BMI), age, and the grades of canal stenosis and disc
degeneration. After additional adjustment for pain sensitivity including total PSQ and PSQminor, there was no difference in VAS for back pain/leg pain between genders. On the SF36 women demonstrated a lower quality of life than men in terms of Physical Function, Role
Physical, Bodily Pain, General Health, and Physical Component Summary. Each gender group
analysis showed that pain sensitivity was associated with symptom severity and disability
caused by LSS in both women and men.
Limitations: The present study did not evaluate psychological factors including
catastrophizing and/or undiagnosed personal traits which possibly can influence the severity
of symptoms from LSS.
Conclusions: Women showed increased low back pain and leg pain due to degenerative LSS
compared to men. The current study demonstrates that this difference in symptom severity
may be partly mediated by pain sensitivity.
Key words: Lumbar spinal stenosis, gender difference, visual analog scale, Oswestry
Disability Index, Short Form-36, pain sensitivity
Publisher
American Society of Interventional Pain Physicians
Subject
Anesthesiology and Pain Medicine
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献