Related Experiment Video
Updated: Jul 29, 2026
05:17
Author Spotlight: Scope of LE-ULBD as a Safe, Effective, and Minimally Invasive Approach to Treat Lumbar Spinal Stenosis
Published on: February 9, 2024
1.2K
Social Vulnerability Index is Associated With Increased Emergency Department Utilization and Persistent Opioid Use
Mark A Plantz1, Daniel Herrera1, Jason Tegethoff1
1Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, USA.
Global Spine Journal
|December 22, 2025
Summary
Social vulnerability impacts healthcare use after spine surgery. Patients with higher social vulnerability were more likely to use the emergency department and have persistent opioid use following elective lumbar decompression.
Area of Science:
- Orthopaedic Surgery
- Health Services Research
- Social Determinants of Health
Background:
- Social determinants of health (SDOH) significantly affect outcomes in elective orthopaedic procedures.
- Limited research exists on the impact of SDOH on healthcare resource utilization post-elective spine surgery.
- Understanding these disparities is crucial for equitable patient care.
Purpose of the Study:
- To investigate the influence of social vulnerability on opioid use, healthcare utilization, and patient-reported outcome measures (PROMs) after elective lumbar decompression.
- To identify specific disparities in healthcare resource utilization among patients with social vulnerability.
Main Methods:
- Retrospective analysis of 216 patients undergoing elective 1- or 2-level lumbar decompression (2013-2018).
- Calculation of Centers for Disease Control and Prevention (CDC) Social Vulnerability Index (SVI) scores based on patient residence ZIP codes.
- Comparison of healthcare utilization (opioid use, ED visits, etc.) and PROMs (pain interference, physical function) between socially vulnerable and non-vulnerable groups.
Main Results:
- 58 patients (27%) met criteria for social vulnerability.
- Socially vulnerable patients showed higher rates of emergency department utilization and persistent opioid use at 6 months and 1 year postoperatively.
- Multivariate regression identified SVI as independently associated with pre-operative opioid use, post-operative ED utilization, and persistent opioid use.
Conclusions:
- Social disparities are linked to increased healthcare resource utilization, specifically higher emergency department visits and persistent opioid use, after elective lumbar decompression.
- While patient-reported outcomes were similar, social vulnerability presents significant challenges in managing post-operative care and resource utilization.
- Targeted interventions addressing social determinants of health are needed to mitigate these disparities in spine surgery patients.
