Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
September 28, 2026 · via Europe PMC
Influence of surgical approach on sexual dysfunction following single-level lumbar fusion in men: a propensity-matched analysis.
Jelkin G, Kaghazchi A, Karnati J, +8 more, Adogwa O.
AI summary — for doctors, generated from the abstract only
Anterior lumbar fusion was linked to more sexual dysfunction in men than posterior-only fusion.
What was studied
Propensity-matched multi-institutional cohort of men with single-level lumbar fusion.
Key findings
- Anterior approaches had higher odds at 6 months (OR 2.09).
- Odds remained higher at 9 months (OR 1.93).
- At 12 months odds were still elevated (OR 1.61).
Clinical relevance
Approach choice may affect sexual outcomes.
Who should care
Limitations
Retrospective database study using coded diagnoses and no direct sexual function measures.
Counsel male patients on this risk when choosing an anterior approach.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Sexual dysfunction represents a meaningful yet understudied complication of spine surgery, with substantial implications for quality of life. Differences in surgical exposure between anterior and posterior approaches may influence these outcomes through variation in anatomic disruption, neural risk, and perioperative course. While existing studies have reported select postoperative sexual complications in broad patient populations, comparative data specifically assessing dysfunction by operative approach among men undergoing single-level lumbar fusion remain sparse. This study compared postoperative sexual dysfunction risk following anterior-only versus posterior-only single-level lumbar fusion in men.
Methods
The TriNetX Research Network identified adult men who underwent single-level lumbar fusion between 01/01/2010 and 12/31/2023, with preoperative diagnoses of lumbar, lumbosacral, or thoracolumbar stenosis, spondylolisthesis, scoliosis, myelopathy, or radiculopathy. Patients were categorized by surgical approach as anterior-only or posterior-only fusion. Individuals with complex spinal pathology, preexisting urogenital disease, or prior alternative exposure were excluded. Propensity score matching was used to balance age, ethnicity, and relevant comorbidities. The primary outcome was a composite of postoperative sexual complications, including erectile and ejaculatory disorders, dyspareunia, decreased libido, and testicular or scrotal dysfunction, assessed at 1, 3, 6, 9, and 12 months after surgery.
Results
Of 12,369 eligible patients, 10,606 underwent posterior-only fusion and 1763 underwent anterior-only fusion. After propensity score matching, 1761 patients remained in each cohort with well-balanced baseline characteristics. Compared to posterior-only, anterior-only fusions were associated with significantly higher odds of sexual dysfunction at six (OR 2.09, 95% CI[1.12-3.88]), nine (OR 1.93, 95% CI[1.15-3.25]), and twelve months (OR 1.61, 95% CI[1.03-2.52]).
Conclusions
In this multi-institutional cohort of adult men undergoing single-level lumbar fusion, anterior exposure was associated with increased odds of delayed postoperative sexual dysfunction compared to posterior-only approaches, underscoring surgical approach as a clinically important contributor to postprocedural sexual outcomes.
DOI
10.1016/j.jocn.2026.112314
PMID
42805024
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
Want more like this?
Browse more from the feed. A free account unlocks the full feed, saving and communities.
Back to the research feed