Abstract：
The goals were to ascertain if differences in imaging/clinical characteristics between women and men were associated with differences in fusion for lumbar degenerative spondylolisthesis.
Patients had preoperative standing radiographs, CT scans, and intraoperative fluoroscopic images. Symptoms and comorbidity were obtained from patients; procedure (fusion-surgery or decompression-alone) was obtained from intraoperative records. With fusion surgery as the dependent variable, men and women were compared in multivariable logistic regression models with clinical/imaging characteristics as independent variables. The sample was dichotomized, and analyses were repeated with separate models for men and women.
For 380 patients (mean age 67, 61% women), women had greater translation, listhesis angle, lordosis, and pelvic incidence, and less diastasis and disc height (all p ≤ 0.03). The rate of fusion was higher for women (78% vs. 65%; OR 1.9, p = 0.008). Clinical/imaging variables were associated with fusion in separate models for men and women. Among women, in the final multivariable model, less comorbidity (OR 0.5, p = 0.05), greater diastasis (OR 1.6, p = 0.03), and less anterior disc height (OR 0.8, p = 0.0007) were associated with fusion. Among men, in the final multivariable model, opioid use (OR 4.1, p = 0.02), greater translation (OR 1.4, p = 0.0003), and greater diastasis (OR 2.4, p = 0.0002) were associated with fusion.
There were differences in imaging characteristics between men and women, and women were more likely to undergo fusion. Differences in fusion within groups indicate that decisions for fusion were based on composite assessments of clinical and imaging characteristics that varied between men and women.
Patients had preoperative standing radiographs, CT scans, and intraoperative fluoroscopic images. Symptoms and comorbidity were obtained from patients; procedure (fusion-surgery or decompression-alone) was obtained from intraoperative records. With fusion surgery as the dependent variable, men and women were compared in multivariable logistic regression models with clinical/imaging characteristics as independent variables. The sample was dichotomized, and analyses were repeated with separate models for men and women.
For 380 patients (mean age 67, 61% women), women had greater translation, listhesis angle, lordosis, and pelvic incidence, and less diastasis and disc height (all p ≤ 0.03). The rate of fusion was higher for women (78% vs. 65%; OR 1.9, p = 0.008). Clinical/imaging variables were associated with fusion in separate models for men and women. Among women, in the final multivariable model, less comorbidity (OR 0.5, p = 0.05), greater diastasis (OR 1.6, p = 0.03), and less anterior disc height (OR 0.8, p = 0.0007) were associated with fusion. Among men, in the final multivariable model, opioid use (OR 4.1, p = 0.02), greater translation (OR 1.4, p = 0.0003), and greater diastasis (OR 2.4, p = 0.0002) were associated with fusion.
There were differences in imaging characteristics between men and women, and women were more likely to undergo fusion. Differences in fusion within groups indicate that decisions for fusion were based on composite assessments of clinical and imaging characteristics that varied between men and women.
摘要：
目的：目的是确定男女影像学/临床特征的差异是否与腰椎退行性滑脱的融合差异相关。
方法：患者术前站立X光片，CT扫描,术中透视图像。从患者获得症状和合并症；手术（融合手术或单独减压）从术中记录中获得。以融合手术为因变量，在以临床/影像学特征为自变量的多变量logistic回归模型中比较了男性和女性.样本被二分法，并对男性和女性进行了单独的模型重复分析。
结果：对于380名患者（平均年龄67岁，61%为女性），女性有更多的翻译，斜度角度,脊柱前凸,和骨盆发病率，和较少的舒张和椎间盘高度（所有p≤0.03）。女性的融合率较高(78%vs.65%；OR1.9，p=0.008）。临床/影像学变量与男性和女性不同模型中的融合相关。在女性中,在最终的多变量模型中，共病较少(OR0.5，p=0.05)，更大的舒张（OR1.6，p=0.03），前盘高度较低（OR0.8，p=0.0007）与融合相关。在男性中,在最终的多变量模型中，阿片类药物的使用（OR4.1，p=0.02），更大的平移(OR1.4，p=0.0003)，和更大的舒张(OR2.4,p=0.0002)与融合相关。
结论：男性和女性的影像学特征存在差异，女性更有可能接受融合。组内融合的差异表明融合的决定是基于男性和女性之间不同的临床和影像学特征的综合评估。
方法：患者术前站立X光片，CT扫描,术中透视图像。从患者获得症状和合并症；手术（融合手术或单独减压）从术中记录中获得。以融合手术为因变量，在以临床/影像学特征为自变量的多变量logistic回归模型中比较了男性和女性.样本被二分法，并对男性和女性进行了单独的模型重复分析。
结果：对于380名患者（平均年龄67岁，61%为女性），女性有更多的翻译，斜度角度,脊柱前凸,和骨盆发病率，和较少的舒张和椎间盘高度（所有p≤0.03）。女性的融合率较高(78%vs.65%；OR1.9，p=0.008）。临床/影像学变量与男性和女性不同模型中的融合相关。在女性中,在最终的多变量模型中，共病较少(OR0.5，p=0.05)，更大的舒张（OR1.6，p=0.03），前盘高度较低（OR0.8，p=0.0007）与融合相关。在男性中,在最终的多变量模型中，阿片类药物的使用（OR4.1，p=0.02），更大的平移(OR1.4，p=0.0003)，和更大的舒张(OR2.4,p=0.0002)与融合相关。
结论：男性和女性的影像学特征存在差异，女性更有可能接受融合。组内融合的差异表明融合的决定是基于男性和女性之间不同的临床和影像学特征的综合评估。
