Objective:

Existing literature demonstrates significant differences in morbidity and mortality measures between males and females undergoing various spinal surgeries, however, studies of lumbar fusion surgery are limited. To investigate the impact of patient sex on 30-day perioperative outcomes of elective lumbar fusion spine surgery.

Methods:

Patients who underwent lumbar fusion between 2015-2018 were reviewed from the ACS-NSQIP database. Propensity score matching was used to determine whether sex had an influence on 30-day perioperative complications.

Results:

13,715 PLF cases, 21,993 PLIF/TLIF cases, and 8,818 ALIF/LLIF cases met inclusion criteria and were reviewed. Females were more likely to be of older age, functionally dependent, taking steroids for chronic conditions, and have a higher body mass index (BMI) and lower preoperative hematocrit level. Males were more likely to be Caucasian, smokers, and have diabetes mellitus, hypertension, and bleeding disorders. In all cohorts, except for a higher incidence of urinary tract infection (UTI) in females and myocardial infarction (MI) in males, there were no significant differences in morbidity and mortality between males and females.

Conclusions:

Several differences in demographics and baseline health status exist between males and females undergoing lumbar fusion. When attempting to control for comorbid conditions using propensity score matching, we found that sex was an independent predictor of UTI in females and MI in males across major morbidity and mortality categories in patients undergoing lumbar fusion surgery.