Trends and Disparities in Cervical Spine Fusion Procedures Utilization in the New York State

Feng, Rui; Finkelstein, Mark; Bilal, Khawaja; Oermann, Eric K.; Palese, Michael; Caridi, John M.

doi:10.1097/brs.0000000000002438

Cited by 23 publications

(28 citation statements)

References 14 publications

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“…For instance, patients were willing to go to hospitals close to their homes and high-volume hospitals with high-volume surgeons were usually far from their homes. Recent studies also indicated that minorities, such as African Americans or Hispanics, and patients with Medicaid had difficulty in accessibility to operation at high-volume hospitals (49). Thus, race and socio-economic status may be responsible for the inaccessibility of urban patients to the high-quality treatment.…”

Section: Potential Mechanism and Clinical Applicationmentioning

confidence: 99%

Relationship between surgeon volume and outcomes in spine surgery: a dose-response meta-analysis

Li¹,

Zhong²,

Li³

et al. 2018

Ann. Transl. Med

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Background: The relationship between surgeon volume and outcomes in spine surgery is unclear and published studies report inconsistent results. Therefore, a dose-response meta-analysis was conducted to clarify the influence of surgeon volume on outcomes in spine surgery.Methods: PubMed, Embase, and The Cochrane Library were systematically searched without language limitation for observational studies which investigated the relationship between surgeon volume and outcomes in spine surgery. The primary outcome was postoperative morbidity and the secondary outcomes consisted of mortality, length of hospital stay, readmission, and hospital costs. For binary variable and continuous variable, odds ratios (ORs) with 95% CIs and weighted mean differences (WMDs) with 95% CIs were pooled respectively. Additionally, a dose-response meta-analysis was performed for the primary outcome.Results: Eleven studies with 1,986,545 patients were included in the current meta-analysis. Pooled estimate indicated that a higher surgeon volume was associated with lower postoperative morbidity (OR,

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Section: Potential Mechanism and Clinical Applicationmentioning

confidence: 99%

Relationship between surgeon volume and outcomes in spine surgery: a dose-response meta-analysis

Li¹,

Zhong²,

Li³

et al. 2018

Ann. Transl. Med

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“…1-3 In recent years, there has been increased interest in understanding the influence of socioeconomic factors on population health. Although the effect of individual-level socioeconomic determinants, such as income and education, account for some of the variance in outcomes, 4-7 neighborhood-level factors, such as living environment and access to social services may also influence patient health. 8-14 The impact of these neighborhood-level socioeconomic factors remains unclear in patients undergoing spine surgery.…”

mentioning

confidence: 99%

Association Between Neighborhood-Level Socioeconomic Disadvantage and Patient-Reported Outcomes in Lumbar Spine Surgery

et al. 2022

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BACKGROUND: Despite an increased understanding of the impact of socioeconomic status on neurosurgical outcomes, the impact of neighborhood-level social determinants on lumbar spine surgery patient-reported outcomes remains unknown. OBJECTIVE: To evaluate the impact of geographic social deprivation on physical and mental health of lumbar surgery patients. METHODS: A single-center retrospective cohort study analyzing patients undergoing lumbar surgery for degenerative disease from 2015 to 2018 was performed. Surgeries were categorized as decompression only or decompression with fusion. The area deprivation index was used to define social deprivation. Study outcomes included preoperative and change in Patient-Reported Outcomes Measurement (PROMIS) physical function (PF), pain interference (PI), depression, and anxiety (mean follow-up: 43.3 weeks). Multivariable imputation was performed for missing data. One-way analysis of variance and multivariable linear regression were used to evaluate the association between area deprivation index and PROMIS scores. RESULTS: In our cohort of 2010 patients, those with the greatest social deprivation had significantly worse mean preoperative PROMIS scores compared with the least-deprived cohort (mean difference [95% CI]-PF: À2.5 [À3.7 to À1.4];

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“…Ultimately, 24 articles were included in the systematic review (Table 1). Of the 18 articles that investigated racial disparities in spine surgery between African Americans (AAs) and Whites (Ws), 5,[24][25][26][28][29][30][31][32][37][38][39][40][41][42][43][44][45] 15 found adverse disparities for AAs. 5,[24][25][26][28][29][30][37][38][39][40][41][42]44,45 Six articles did not specifically compare Ws and AAs.…”

Section: Study Descriptionsmentioning

confidence: 99%

“…Of the 18 articles that investigated racial disparities in spine surgery between African Americans (AAs) and Whites (Ws), 5,[24][25][26][28][29][30][31][32][37][38][39][40][41][42][43][44][45] 15 found adverse disparities for AAs. 5,[24][25][26][28][29][30][37][38][39][40][41][42]44,45 Six articles did not specifically compare Ws and AAs. 27,33,[46][47][48][49] One article reported on racial disparities between Asian Americans and Ws.…”

Section: Study Descriptionsmentioning

confidence: 99%

Racial Disparities in Spine Surgery

Ikwuezunma

Mun

et al. 2022

Clinical Spine Surgery: A Spine Publication

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Study Design: Systematic Review. Objectives: To synthesize previous studies evaluating racial disparities in spine surgery. Methods: We queried PubMed, Embase, Cochrane Library, and Web of Science for literature on racial disparities in spine surgery. Our review was constructed in accordance with Preferred Reporting Items and Meta-analyses guidelines and protocol. The main outcome measures were the occurrence of racial disparities in postoperative outcomes, mortality, surgical management, readmissions, and length of stay. Results: A total of 1753 publications were assessed. Twenty-two articles met inclusion criteria. Seventeen studies compared Whites (Ws) and African Americans (AAs) groups; 14 studies reported adverse outcomes for AAs. When compared with Ws, AA patients had higher odds of postoperative complications including mortality, cerebrospinal fluid leak, nervous system complications, bleeding, infection, in-hospital complications, adverse discharge disposition, and delay in diagnosis. Further, AAs were found to have increased odds of readmission and longer length of stay. Finally, AAs were found to have higher odds of nonoperative treatment for spinal cord injury, were more likely to undergo posterior approach in the treatment of cervical spondylotic myelopathy, and were less likely to receive cervical disk arthroplasty compared with Ws for similar indications. Conclusions: This systematic review of spine literature found that when compared with W patients, AA patients had worse health outcomes. Further investigation of root causes of these racial disparities in spine surgery is warranted.

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Trends and Disparities in Cervical Spine Fusion Procedures Utilization in the New York State

Abstract: 3.

Cited by 23 publications

References 14 publications

Relationship between surgeon volume and outcomes in spine surgery: a dose-response meta-analysis

Relationship between surgeon volume and outcomes in spine surgery: a dose-response meta-analysis

Association Between Neighborhood-Level Socioeconomic Disadvantage and Patient-Reported Outcomes in Lumbar Spine Surgery

Racial Disparities in Spine Surgery

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