PMID- 33962387
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240521
IS  - 1547-5646 (Electronic)
IS  - 1547-5646 (Linking)
VI  - 35
IP  - 1
DP  - 2021 May 7
TI  - Disparities in outcomes after spine surgery: a Michigan Spine Surgery Improvement 
      Collaborative study.
PG  - 91-99
LID - 10.3171/2020.10.SPINE20914 [doi]
AB  - OBJECTIVE: Most studies on racial disparities in spine surgery lack data 
      granularity to control for both comorbidities and self-assessment metrics. 
      Analyses from large, multicenter surgical registries can provide an enhanced 
      platform for understanding different factors that influence outcome. In this 
      study, the authors aimed to determine the effects of race on outcomes after 
      lumbar surgery, using patient-reported outcomes (PROs) in 3 areas: the North 
      American Spine Society patient satisfaction index, the minimal clinically 
      important difference (MCID) on the Oswestry Disability Index (ODI) for low-back 
      pain, and return to work. METHODS: The Michigan Spine Surgery Improvement 
      Collaborative was queried for all elective lumbar operations. Patient 
      race/ethnicity was categorized as Caucasian, African American, and "other." 
      Measures of association between race and PROs were calculated with generalized 
      estimating equations (GEEs) to report adjusted risk ratios. RESULTS: The African 
      American cohort consisted of a greater proportion of women with the highest 
      comorbidity burden. Among the 7980 and 4222 patients followed up at 1 and 2 years 
      postoperatively, respectively, African American patients experienced the lowest 
      rates of satisfaction, MCID on ODI, and return to work. Following a GEE, African 
      American race decreased the probability of satisfaction at both 1 and 2 years 
      postoperatively. Race did not affect return to work or achieving MCID on the ODI. 
      The variable of greatest association with all 3 PROs at both follow-up times was 
      postoperative depression. CONCLUSIONS: While a complex myriad of socioeconomic 
      factors interplay between race and surgical success, the authors identified 
      modifiable risk factors, specifically depression, that may improve PROs among 
      African American patients after elective lumbar spine surgery.
FAU - Macki, Mohamed
AU  - Macki M
AD  - 1Department of Neurosurgery, Henry Ford Hospital, Detroit.
FAU - Hamilton, Travis
AU  - Hamilton T
AD  - 1Department of Neurosurgery, Henry Ford Hospital, Detroit.
FAU - Lim, Seokchun
AU  - Lim S
AD  - 1Department of Neurosurgery, Henry Ford Hospital, Detroit.
FAU - Telemi, Edvin
AU  - Telemi E
AD  - 1Department of Neurosurgery, Henry Ford Hospital, Detroit.
FAU - Bazydlo, Michael
AU  - Bazydlo M
AD  - 1Department of Neurosurgery, Henry Ford Hospital, Detroit.
FAU - Nerenz, David R
AU  - Nerenz DR
AD  - 1Department of Neurosurgery, Henry Ford Hospital, Detroit.
FAU - Zakaria, Hesham Mostafa
AU  - Zakaria HM
AD  - 1Department of Neurosurgery, Henry Ford Hospital, Detroit.
FAU - Schultz, Lonni
AU  - Schultz L
AD  - 1Department of Neurosurgery, Henry Ford Hospital, Detroit.
FAU - Khalil, Jad G
AU  - Khalil JG
AD  - Departments of2Orthopaedic Surgery and.
FAU - Perez-Cruet, Miguelangelo J
AU  - Perez-Cruet MJ
AD  - 3Neurosurgery, Beaumont Health System, Royal Oak; and.
FAU - Aleem, Ilyas S
AU  - Aleem IS
AD  - Departments of4Orthopaedic Surgery and.
FAU - Park, Paul
AU  - Park P
AD  - 5Neurosurgery, University of Michigan Hospital, Ann Arbor, Michigan.
FAU - Schwalb, Jason M
AU  - Schwalb JM
AD  - 1Department of Neurosurgery, Henry Ford Hospital, Detroit.
FAU - Abdulhak, Muwaffak M
AU  - Abdulhak MM
AD  - 1Department of Neurosurgery, Henry Ford Hospital, Detroit.
FAU - Chang, Victor
AU  - Chang V
AD  - 1Department of Neurosurgery, Henry Ford Hospital, Detroit.
LA  - eng
PT  - Journal Article
DEP - 20210507
PL  - United States
TA  - J Neurosurg Spine
JT  - Journal of neurosurgery. Spine
JID - 101223545
SB  - IM
OTO - NOTNLM
OT  - African American
OT  - disparity
OT  - lumbar
OT  - race
OT  - satisfaction
EDAT- 2021/05/08 06:00
MHDA- 2021/05/08 06:01
CRDT- 2021/05/07 20:39
PHST- 2020/05/20 00:00 [received]
PHST- 2020/10/12 00:00 [accepted]
PHST- 2021/05/08 06:01 [medline]
PHST- 2021/05/08 06:00 [pubmed]
PHST- 2021/05/07 20:39 [entrez]
AID - 10.3171/2020.10.SPINE20914 [doi]
PST - epublish
SO  - J Neurosurg Spine. 2021 May 7;35(1):91-99. doi: 10.3171/2020.10.SPINE20914.