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The Effect of Patient Race on Extent of Functional Improvement After Cervical Spine Surgery
Aladine Elsamadicy1, Owoicho Adogwa, Elizabeth Reiser
1*Division of Neurosurgery, Duke University Medical Center, Durham, NC †Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN ‡Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas.
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.
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