Analysis of the factors associated with sexual health improvement in patients who underwent surgical management for adult spine deformity.
van Schaik D, Baroncini A, et al. • European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society • 2025
Long-segment ASD surgery could improve sexual health, which was correlated to physical activity improvement, severe deformity with worse preoperative quality of life, and better postoperative sagittal correction.
Key Findings
Results
Moderate correlations were found between ODI sexual health question (Q8) and multiple patient-reported outcome measures, confirmed by Principal Component Analysis.
Moderate correlations were revealed between ODI and COMI-back, SRS-22, and SF-36 items
Correlations were confirmed with Principal Component Analysis (PCA)
Data from 880 patients were collected from a multicentric retrospective study based on a prospectively collected ASD database
Patients had a minimum 2-year follow-up after surgical correction
Results
Non-response to the preoperative sexual health question (ODI Q8) was associated with older age, worse sagittal imbalance, and specific nationality.
Three main factors were identified as associated with non-response to Q8: older age, worse sagittal imbalance, and specific nationality
Non-response to Q8 was correlated to age and nationality
Non-response was assessed by comparing patients who did not answer the preoperative Q8 to those who did
Results
Patients who showed improvement in sexual health at 2-year follow-up were characterized by worse baseline quality of life, older age with greater sagittal correction, and better improvement in physical activity.
Improvement in sexual health was defined as a 1-point decrease on ODI Q8
Improved patients had worse baseline quality of life compared to non-improved patients
Greater sagittal correction was associated with sexual health improvement, particularly in older patients
Better improvement of the level of physical activity was associated with sexual health improvement
Comparisons were made between improved and non-improved patients at 2-year follow-up
Conclusions
Surgical management for adult spinal deformity can improve sexual health, with improvement correlated to physical activity improvement, severe deformity with worse preoperative quality of life, and better postoperative sagittal correction.
The study used a multicentric retrospective design based on a prospectively collected ASD database
880 patients with 2-year follow-up data were analyzed
Sexual health impact of spinal deformity can lead to depression and relationship distress
The literature concerning sexual health aspects in spinal deformity is described as 'still scarce'
What This Means
This research examined which factors predict improvement in sexual health after surgery for adult spinal deformity (ASD), a condition where the spine curves or misaligns in ways that cause significant physical and quality-of-life problems. The researchers analyzed data from 880 patients across multiple centers, looking at validated questionnaires measuring pain, disability, and quality of life, and specifically tracking responses to a sexual health question from the Oswestry Disability Index (ODI) over a two-year period after surgery.
The study found that patients who were more likely to skip the sexual health question before surgery tended to be older, have worse spinal alignment (sagittal imbalance), or be from certain nationalities. Among patients who did respond, those who experienced improvement in sexual health after surgery tended to have had worse quality of life before surgery, achieved greater correction of their spinal alignment during surgery, and showed better improvement in their physical activity levels after surgery. This suggests that patients with more severe deformity who achieve meaningful surgical correction and become more physically active may experience the most benefit in sexual health.
This research is significant because sexual health is an often-overlooked dimension of recovery from spine surgery, and poor sexual health can contribute to depression and relationship difficulties. The findings suggest that surgical correction of adult spinal deformity can positively impact patients' sexual health, particularly when surgery significantly improves spinal alignment and enables greater physical activity. However, the study also highlights that older patients and those with more severe imbalance may be less likely to report on this aspect of their health, pointing to the need for clinicians to proactively address sexual health in their assessments.
van Schaik D, Baroncini A, Boissiere L, Larrieu D, Goudman L, Pizones J, et al.. (2025). Analysis of the factors associated with sexual health improvement in patients who underwent surgical management for adult spine deformity.. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. https://doi.org/10.1007/s00586-025-08746-8