Lumbar spine surgery in Israeli Arabs and Jews: A comparative study with emphasis on pain perception

Background: Surgery for spinal stenosis is a frequent procedure in elderly patients. Presentation, hospital course, and outcome of disease including pain perception may vary among patients of different ethnic origin. Objectives: To evaluate whether differences in various medical indicators can explain differences in pain perception between two ethnic groups. Methods: We conducted a case-control study on the experience of two spinal units treating a mixed Arab and Jewish population, and compared the data on 85 Arab and 189 Jewish patients undergoing spinal lumbar surgery. Results: Arab patients were younger (P= 0.027), less educated (P< 0.001), had a higher body mass index (P= 0.004) and included a higher proportion of diabetics (P= 0.013). Preoperative pain intensity (P= 0.023) and functional disability (P= 0.005) were more prominent, and factors associated with pre- or postoperative pain perception differed between the two ethnic groups. Despite these differences, results on follow-up were similar with respect to pain perception and level of disability. Conclusions: A better understanding of ethnic differences is crucial for predicting surgery outcomes.