Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 1;36(6):243-252.
doi: 10.1097/BSD.0000000000001383. Epub 2022 Aug 22.

Racial Disparities in Spine Surgery: A Systematic Review

Kevin Mo  1 , Ijezie Ikwuezunma  1 , Frederick Mun  1 , Carlos Ortiz-Babilonia  1 , Kevin Y Wang  1 , Krishna V Suresh  1 , Arman Uppal, Ishaan Sethi, Addisu Mesfin  2 , Amit Jain  1
Affiliations

Racial Disparities in Spine Surgery: A Systematic Review

Kevin Mo et al. Clin Spine Surg. .

Abstract

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.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Alosh H, Riley LH, Skolasky RL. Insurance status, geography, race, and ethnicity as predictors of anterior cervical spine surgery rates and in-hospital mortality: an examination of United States trends from 1992 to 2005. Spine. 2009;34:1956–1962.
    1. Bearden D, Allman R, McDonald R, et al. Age, race, and gender variation in the utilization of coronary artery bypass surgery and angioplasty in SHEP. J Am Geriatr Soc. 1994;42:1143–1149.
    1. Bhopal R. Is research into ethnicity and health racist, unsound, or important science? BMJ. 1997;314:1751.
    1. Carey TS, Mills Garrett J. The relation of race to outcomes and the use of health care services for acute low back pain. Spine. 2003;28:390–394.
    1. Skolasky RL, Thorpe RJ, Wegener ST, et al. Complications and mortality in cervical spine surgery: Racial differences. Spine. 2014;39:1506–1512.

Publication types