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The following is a summary of “Effect and prognosis of thoracolumbar fracture combined with incomplete spinal cord injury on male sexual function,” published in the February 2025 issue of the Journal of Orthopaedic Surgery and Research by Gao et al.

Severe thoracolumbar fractures often result in spinal cord injury (SCI), which can significantly impact male sexual function, leading to erectile dysfunction and premature ejaculation. This study aimed to evaluate the factors influencing sexual dysfunction and its prognosis in male patients with thoracolumbar fractures and incomplete SCI. A total of 117 male patients were retrospectively analyzed, with data collected at multiple time points: prior to injury, three months post-injury, two years post-injury, and at final follow-up. 

The assessment of spinal cord and sexual function included the American Spinal Injury Association (ASIA) impairment scale, the International Index of Erectile Function-5 (IIEF-5) score, the Premature Ejaculation Diagnostic Tool (PEDT) score, and the International Spinal Cord Injury Male Sexual Function Basic Data Set. Changes in IIEF-5 and PEDT scores over time were analyzed using the Wilcoxon signed-rank test, while Kendall’s Tau-b correlation was applied to identify factors influencing sexual dysfunction and its recovery. The results demonstrated a significant decline in erectile function following injury, with the mean IIEF-5 score dropping from 19.5 ± 6.4 pre-injury to 8.7 ± 8.0 post-injury (p < 0.05). 

Similarly, premature ejaculation symptoms worsened, as indicated by an increase in PEDT scores from 5.3 ± 3.1 pre-injury to 6.9 ± 5.2 post-injury (p < 0.05). At the two-year follow-up, erectile function showed substantial improvement, with the IIEF-5 score increasing to 17.5 ± 7.1, suggesting partial recovery. However, premature ejaculation symptoms remained relatively unchanged, with the PEDT score at 6.4 ± 5.1, indicating a persistent issue for some patients. Correlation analysis revealed a strong association between the severity and location of the SCI and the extent of sexual dysfunction post-injury. Notably, approximately 70% of patients experienced sexual function recovery to pre-injury levels within two years postoperatively. These findings underscore the importance of early intervention and individualized rehabilitation strategies to improve sexual health outcomes in male patients with thoracolumbar fractures and incomplete SCI.

Source: josr-online.biomedcentral.com/articles/10.1186/s13018-025-05587-5