The Effect of Patient Race on Extent of Functional Improvement After Cervical Spine Surgery. Issue 9 (May 2016)

• Record Type: Journal Article
• Authors: Elsamadicy, Aladine; Adogwa, Owoicho; Reiser, Elizabeth; Fatemi, Parastou; Cheng, Joseph; Bagley, Carlos
• Is Part Of: Spine. Volume 41:Issue 9(2016)
• Publication Date: 2016-05
• Subjects: ACDF -- cervical spine -- disparity -- mental component score -- neck disability index -- physical component score -- race -- spine surgery -- surgical outcomes -- visual analog score; Spine -- Abnormalities -- Periodicals; Spine -- Diseases -- Periodicals; Spine -- Surgery -- Periodicals; 616.73005
• DOI: 10.1097/BRS.0000000000001346
• Languages: English
• ISSNs: 0362-2436

Abstract

Abstract : Study Design: A longitudinal cohort study. Objective: In this study, we set out to assess the association between racial differences and health outcomes after anterior cervical discectomy and fusion (ACDF). Summary of Background Data: Although racial disparities in the use of surgical procedures are well established, relationships between race and patient-reported outcomes measures after ACDF have not been previously assessed. Methods: Sixty adult patients (black patients: 28, white patients: 32) undergoing ACDF at Duke University Medical Center were included in this study. Enrollment criteria included available demographic, surgical, and clinical outcome data. All patients had prospectively collected patient-reported outcomes measures and a minimum 1-year follow-up. Patients completed the Neck Disability Index (NDI), Short-Form 12 (SF-12), and Visual Analog Pain Scale (VAS) before surgery, and then at 3, 6, and 12 months after surgery. Clinical outcomes and complication rates were compared between both patient cohorts. Results: Baseline characteristics were similar between both cohorts. The median [interquartile range] number of levels fused was similar between both patient cohorts 2 [1–2], P = 0.41. There was no significant difference between cohorts in the incidence of nerve root injury ( P = 0.99) or incidental durotomy ( P = 0.31). At 3 months postoperatively, both cohorts demonstrated similar improvement in VAS-neck pain ( P = 0.75), NDI ( P = 0.31), SF-12 physical component score (PCS) ( P = 0.82), and SF-12 mental component score (MCS) ( P = 0.43). These results were durable through 1 year. At 1 year, both the black and white patients demonstrated similar improvement from baseline in NDI ( P = 0.36), VAS neck pain ( P = 0.35), SF-12 PCS ( P = 0.18), and SF-12 MCS ( P = 0.56). Conclusion: Our study suggests that at 1 year, there were no substantial differences in between races in patient-reported outcomes measures after ACDF. Both black and white patients expressed similar improvement from baseline in all outcomes metrics. Level of Evidence: 3