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Spinal Fusion Outcomes Worse for Black Patients, Large Study Finds

Last Updated: January 29, 2020.

WEDNESDAY, Jan. 29, 2020 (HealthDay News) -- Black Americans who have lower spinal fusion surgery have more complications, spend more time in the hospital and have higher costs than white patients, new research shows.

For the study, the researchers analyzed the discharge records of nearly 268,000 patients in California, Florida, New York, Maryland and Kentucky who had this common surgery from 2007 through 2014.

Of those, nearly 78% were white and 6.5% were black.

Compared to white patients, black patients were 8% more likely to have complications specific to spinal surgery and 14% more likely to have general complications, the findings showed.

In addition, black patients were more likely to be readmitted to the hospital, and also were more likely to have a longer hospital stay and higher costs.

The racial differences remained significant even after the investigators accounted for factors such as other medical conditions, surgical techniques and where patients were treated.

The study was published online Jan. 15 in the journal Spine. Dr. Robert White, an anesthesiologist at NewYork-Presbyterian/Weill Cornell Medicine in New York City, led the investigation.

"Our study reaffirms the concern that black race remains a social determinant of health impacting equity in surgical outcomes," the authors wrote.

"Previous research has identified race as a social determinant of health that impacts outcomes after lumbar spinal fusion surgery," they added.

The racial disparities might be due to differences in the characteristics of black patients (such as higher rates of diabetes and obesity) or where they're treated (for example, at hospitals that do fewer spinal fusion surgeries), the authors pointed out in a journal news release.

"Hospital systems and providers should adopt methods to promote equity in care, including employee educational programs focusing on health care disparities and the impact of unequal care, and through the utilization of standardized protocol-based care, such as Enhanced Recovery After Surgery programs, that can reduce the impact of implicit bias on post-surgical outcomes," White's team concluded.

More information

The American Academy of Orthopaedic Surgeons has more on spinal fusion.

SOURCE: Spine, news release, Jan. 15, 2020


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