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Review
. 2025 Mar;13(2):373-381.
doi: 10.1007/s43390-024-01012-9. Epub 2024 Nov 27.

Healthcare disparities in adult and pediatric spinal deformity: a state of the art review

Lancelot Benn  1 , Tarek Yamout  2 , Mauro Costa Morais Tavares Junior  3 , Adwin Denasty  2 , Laurel C Blakemore  4 , Serena S Hu  5 , Qusai Hammouri  6 , Joe Minchew  7 , Isaac Karikari  8 , Joseph Osorio  9 , Olavo Biraghi Letaif  3 , Addisu Mesfin  10
Affiliations
Review

Healthcare disparities in adult and pediatric spinal deformity: a state of the art review

Lancelot Benn et al. Spine Deform. 2025 Mar.

Abstract

Purpose: A health disparity refers to a greater disease burden or negative health outcomes influenced by social, economic, and environmental factors. Numerous studies in the surgical literature show that social drivers of health affect health outcomes. Similar disparities may affect treatment and outcomes of spine deformity patients. This study aims to review existing literature on healthcare disparities in patients with spinal deformities.

Methods: A comprehensive search of articles from 1/2002 to 7/2024 in two databases included keywords and Medical Subject Heading terms: "health disparities," "scoliosis," "social determinant of health," "disparities," "spine deformity," and "race". The 22 studies that met the inclusion criteria were U.S.-based, English-language, peer-reviewed research covering all age groups. Exclusion criteria excluded studies unrelated to spinal deformity and case reports.

Results: The search resulted in 22 potential articles investigating health care disparities in spinal deformity patients. Black patients were noted to present with disease progression compared to White patients. Females have a longer length of stay (LOS) than males. The Black and Hispanic patients had longer LOS than Whites. The privately insured patients were more likely to receive timely care than Medicaid recipients.

Conclusion: The consensus across much of the literature reviewed indicate that surgeon volume, hospital volume, sex/gender, race/ethnicity, socioeconomic status, and insurance status impact patient outcomes in adult and pediatric spinal deformity. Prospective studies and solutions to address these disparities are needed.

Level of evidence: Level III.

Keywords: Health disparities; Insurance; Race; Sex; Spine deformity; Surgeon volume.

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Conflict of interest statement

Declarations. Conflict of interest: Lancelot Benn declares that he has no conflict of interest. Tarek Yamout declares that he has no conflict of interest. Adwin Denasty declares that he has no conflict of interest. Mauro Costa Morais Tavares Junior declares that he has no conflict of interest. Laurel C. Blakemore: consulting agreement Medtronic, Royalties Stryker Spine, BOD for Scoliosis Research Society, Pediatric Spine Foundation, committee member POSNA, Chair of Medical Advisory Board Shriner’s Hospitals for Children. Serena S. Hu declares that she has no conflict of interest relevant to this article. Qusai Hammouri declares that he has no conflict of interest. Joe Minchew declares that he has no conflict of interest. Isaac Karikari,MD declares that he has no conflict of interest. Joseph Osorio declares that he has no conflict of interest. Olavo Biraghi Letaif declares that he has no conflict of interest. Addisu Mesfin owns Equity in Axiomed, Efficient Surgical Apps, Grant support: Nuvasive, Consultant: Nuvasive, serves on committees of SRS, CSRS, LSRS, NASS, JRGOS, AOA. Ethical approval: This article does not contain any studies with human participants or animals performed by any of the authors.

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