Does Gynecologic Surgery Contribute to Low Back Problems in Later Life? An Analysis of the Women’s Health and Aging Study

Abstract 

Ericksen JJ, Bean JF, Kiely DK, Hicks GE, Leveille SG. Does gynecologic surgery contribute to low back problems in later life? An analysis of the Women’s Health and Aging Study.

Objective

To examine whether women with potential injuries to the abdominal and pelvic musculature from past gynecologic surgery are at higher risk for low back pain (LBP).

Design

Cross-sectional population-based study.

Setting

Eastern region of the city and county of Baltimore, MD.

Participants

Disabled women (N=1002) aged 65 and older, 448 of whom reported gynecologic surgery who were participants in the Women’s Health and Aging Study.

Interventions

Not applicable.

Main Outcome Measures

LBP presence in the last year, LBP severity for the last month, and adjudicated lumbar diagnoses (disk disease, stenosis) were examined in relation to reports of surgical menopause or ovarian surgery adjusted for LBP risk factors.

Results

Women with surgical menopause experienced more moderate LBP (adjusted odds ratio [AOR]=1.59; 95% confidence interval [CI], 1.1−2.3) than women without surgical menopause. Women with ovarian surgery also experienced more moderate LBP than women without ovarian surgery, but this association was not statistically significant (AOR=1.39; 95% CI, 0.96–2.09). Gynecologic surgery was not associated with an increased likelihood of lumbar disk disease or stenosis.

Conclusions

Surgical menopause may increase the risk of moderate LBP. Further research is needed to determine how gynecologic surgery might influence low back pathology. Abdominal and pelvic muscle rehabilitation after gynecologic surgery may provide protection from LBP later in life.

Key Words:  Aging , Back pain , Gynecologic surgical procedures , Intervertebral disk displacement , Rehabilitation , Spinal stenosis