Abstract
BACKGROUND AND PURPOSE: Severe thoracolumbar fractures are associated with spinal cord injury that potentially leads to sexual dysfunction. Our purpose is to study the factors that influence sexual dysfunction and its prognosis. METHODS: This study included 117 male patients with thoracolumbar fractures and incomplete spinal cord injury. Data reflecting spinal cord functions and male sexual functions, including American Spinal Injury Association (ASIA) grade, Premature Ejaculation Diagnostic Tool (PEDT) score, International Index of Erectile Function-5(IIEF-5) score and The International Spinal Cord Injury Male Sexual Function Basic Data Set was obtained prior to injury, 3 months post-injury, at 2-year follow-up, and at final follow-up. Wilcoxon signed ranks test is used to verify whether there are differences in IIEF-5 and PEDT scores over time. Kendall's Tau-b correlation analysis is used to investigate factors affecting sexual function impairment and recovery. RESULTS: The IIEF-5 score is 19.5 ± 6.4 before injury and 8.7 ± 8.0 after injury, representing a significant difference. The PEDT score is 5.3 ± 3.1 before injury and 6.9 ± 5.2 after injury, representing a significant difference. The IIEF-5 score at 2-year follow-up was 17.5 ± 7.1, markedly improved relative to post-injury; the average PEDT at 2-year follow-up is 6.4 ± 5.1, showing no considerable difference from post-injury. CONCLUSIONS: Thoracolumbar fractures combined with incomplete spinal cord injury may lead to decreased erectile function and premature ejaculation. The degree of spinal cord injury and the injured segment exhibit a strong correlation with the extent of reduced sexual function post-injury. Approximately 70% of patients have sexual function recover to pre-injury levels at the 2-year postoperative follow-up.