Patients over age 50 with spinal instrumentation can still have satisfying sex lives, according to a recent study published in the Journal of Neurosurgery: Spine.
Spinal instrumentation involves surgically implanting metal and non-metal devices into the spine to give it more stability. Such devices may include screws, hooks, rods, and plates. The procedure may be done for a variety of reasons, from correcting a congenital spinal deformity to treating spinal problems in older age.
The study authors noted that research on sexual function for patients with spinal deformity is lacking and that the matter is not often discussed. They added that many older adults stay sexually active in spite of issues that can interfere with sexual function, such as menopausal hypoactive sexual desire disorder (HSDD), diabetes, and cardiovascular disease.
In the meantime, the elderly population is growing and past research has indicated the prevalence of spinal deformity among this group could be as high as 68%. With these facts in mind, the researchers set out to learn more about sexual function in older patients who had had spinal instrumentation.
For this study, researchers examined data from 54 patients (37 women and 17 men) with a mean age of 70 years who had had instrumentation in the thoracolumbar region (thoracic and lumbar vertebrae) or the pelvis. The participants had had surgery to treat scoliosis (sideways curvature), kyphosis (curve of the upper spine or “hunchback”), and kyphoscoliosis (scoliosis and kyphosis combined).
For assessment of health-related quality of life, each participant completed three questionnaires:
- 14-Item Changes in Sexual Function Questionnaire (assesses sexual functioning)
- Oswestry Disability Index (assesses disability)
- 12-Item Short Form Health Survey (assesses global health)
Information on partner availability, medical comorbidities, and the presence of iliac bolts was also obtained.
Thirteen of the 54 participants reported no sexual problems. Among the 41 remaining patients who did have some degree of sexual dysfunction, the researchers found the following:
- 8 people had mild dysfunction.
- 10 people had moderate dysfunction.
- 23 patients had severe dysfunction.
Most cases of severe sexual dysfunction were attributed to medical problems that interfered with satisfactory sex or the lack of a partner. Some patients’ partners had died or were too ill for sexual activity.
Sexual dysfunction was less common in patients with mild or moderate physical disability. No significant correlation was found with patients’ ages.
Past research had suggested higher rates of sexual problems among patients with iliac bolts. However, in this study, only one participant had symptoms from this type of instrumentation, which might be explained by the way the bolts were placed during surgery.
There were some limitations to this study, such as its retrospective design and the lack of sexual function evaluation before surgery. The study group was also diverse in age, types of spinal deformity, and comorbidities. The authors explained that a prospective controlled study is being planned.
Based on the current evidence, however, they concluded that satisfying sex is possible for many patients with thoracolumbar spinal instrumentation.
Resources
Journal of Neurosurgery: Spine
Hamilton, D. Koko, MD, et al.
“Sexual function in older adults following thoracolumbar to pelvic instrumentation for spinal deformity”
(Full-text. Published online: May 21, 2013)
http://thejns.org/doi/full/10.3171/2013.4.SPINE121078
Medical Xpress
“Sexual function in older adults with thoracolumbar-pelvic instrumentation”
(May 21, 2013)
http://medicalxpress.com/news/2013-05-sexual-function-older-adults-thoracolumbar-pelvic.html
SpineUniverse
Spinasanta, Susan
“What Is Spinal Instrumentation and Spinal Fusion?”
(Updated: September 7, 2012)
http://www.spineuniverse.com/treatments/surgery/what-spinal-instrumentation-spinal-fusion