Association Between Neighborhood-Level Socioeconomic Disadvantage and Patient-Reported Outcomes in Lumbar Spine...

Area of Science:

• Neurosurgery
• Public Health
• Health Services Research

Background:

• Socioeconomic status significantly impacts neurosurgical outcomes.
• The influence of neighborhood social determinants on lumbar spine surgery outcomes is not well understood.

Purpose of the Study:

• To assess the impact of geographic social deprivation on the physical and mental health of patients undergoing lumbar spine surgery.
• To evaluate patient-reported outcomes in relation to social deprivation levels.

Main Methods:

• A retrospective cohort study of 2010 patients undergoing lumbar surgery for degenerative disease (2015-2018).
• Social deprivation was quantified using the area deprivation index.
• Patient-Reported Outcomes Measurement Information System (PROMIS) scores for physical function, pain interference, depression, and anxiety were analyzed pre- and post-operatively.

Main Results:

• Patients in the most deprived areas had significantly worse pre-operative PROMIS scores for physical function, pain interference, depression, and anxiety compared to the least deprived.
• No significant differences in the change of these PROMIS scores were observed at follow-up between deprivation groups.
• Surgical outcomes, in terms of improvement in patient-reported outcomes, were comparable regardless of social deprivation level.

Conclusions:

• Greater social deprivation is associated with poorer pre-operative physical and mental health in lumbar spine surgery patients.
• Lumbar spine surgery provides similar functional and mental health benefits across varying levels of social deprivation.
• Further research is needed to understand social and health factors influencing disease severity and healthcare access for these patients.