RT Journal Article SR Electronic T1 Women Do Not Have Poorer Outcomes After Minimally Invasive Lumbar Fusion Surgery: A Five-Year Follow-Up Study JF International Journal of Spine Surgery JO Int J Spine Surg FD International Society for the Advancement of Spine Surgery SP 7108 DO 10.14444/7108 A1 Lim, Winston Shang Rong A1 Liow, Ming Han Lincoln A1 Seow-Hng Goh, Graham A1 Yeo, William A1 Ling, Zhixing Marcus A1 Yue, Wai-Mun A1 Guo, Chang Ming A1 Tan, Seang Beng YR 2020 UL https://www.ijssurgery.com/content/early/2020/10/09/7108.abstract AB Background: Women undergoing lumbar spine surgery report greater preoperative pain and disability and have less improvement after surgery. There is a paucity of literature on sex-related differences after minimally invasive surgery transforaminal lumbar interbody fusion (MIS TLIF) surgery. We aim to determine whether sex influences outcome after MIS TLIF at 5-year midterm follow-up.Methods: Prospectively collected registry data for 907 patients who underwent MIS TLIF at a single institution from 2004 to 2013 were reviewed. Of these, 296 patients (94 males and 202 females) were reviewed at 5-year follow-up. All patients were assessed preoperatively and postoperatively at 2 and 5 years. Data recorded included patient demographics, Oswestry Disability Index (ODI), Short-Form 36 Physical and Mental component scores (SF-36 PCS and MCS), and the North American Spine Society lumbar spine outcome assessment instrument.Results: Females who underwent MIS TLIF were generally younger (females, 52.2 years; males, 56.1 years; P = .04). Females had significantly poorer preoperative ODI (females, 49.5; males, 41.5; P < .001) and SF-36 PCS (females, 31.9; males, 35.6; P < .01) and MCS (females, 44.9; males, 49.2; P < .01) scores. At 2-year and 5-year follow-up, there were no significant differences in ODI, SF-36, and pain scores between sexes. Both groups reported similar proportions that returned to work and returned to function. There were no differences in proportion of patients who were satisfied or had their expectations fulfilled.Conclusions: Women who undergo MIS TLIF have poorer preoperative function and quality of life than men. However, women demonstrated greater improvement after surgery, attaining similar clinical outcomes at 5-year follow-up.Level of Evidence: 3.