Skip to main content

Racial disparities in outcomes of spinal surgery for lumbar stenosis.

Publication ,  Journal Article
Lad, SP; Bagley, JH; Kenney, KT; Ugiliweneza, B; Kong, M; Bagley, CA; Gottfried, ON; Isaacs, RE; Patil, CG; Boakye, M
Published in: Spine (Phila Pa 1976)
May 15, 2013

STUDY DESIGN: A retrospective, cross-sectional study. OBJECTIVE: To evaluate racial disparities in outcomes of lumbar stenosis surgery. SUMMARY OF BACKGROUND DATA: Racial inequalities have been described in the outcomes of cardiovascular and orthopedic procedures. There have been minimal investigation of racial disparities in complications and costs of lumbar laminectomies and fusions. METHODS: We analyzed the Medicaid data set of Thomson Reuter's MarketScan database. African-American and non-Hispanic white patients who underwent laminectomy or fusion for lumbar stenosis with at least 2 years postoperative data were included. We examined the effect of race on the rate of reoperations, complications, and the cost associated with surgery. RESULTS: African-American patients in the Medicaid database were at no higher risk for reoperation in the 2 years after an operation for lumbar stenosis than white patients (7.14% vs. 7.89%, P = 0.7895). However, we did find that African-American patients were more likely to experience postoperative complications of any kind, even after adjusting for length of hospital stay, comorbidities, sex, and age (adjusted odds ratio = 1.819, P = 0.0123 for immediate complication; adjusted odds ratio = 1.746, P = 0.0141 for 30-d complication; and adjusted odds ratio = 1.611, P = 0.0410 for 90-d complication). White patients had a significantly shorter length of stay (3 vs. 5 d, P < 0.007) and accrued fewer hospital-related costs ($16,148 vs. $24,267, P < 0.0007). African-American patients, despite having more comorbidities in our sample, were prescribed significantly fewer medications in the 2 years after index procedures (91 vs. 138 prescriptions, P < 0.0007) and had fewer medication costs during the 2 years after surgery ($5297 vs. $8450, P < 0.0007). CONCLUSION: At the national level, there are several racial disparities in the rate of complications, length of stay, and costs after surgery for lumbar spinal stenosis. LEVEL OF EVIDENCE: 3.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Spine (Phila Pa 1976)

DOI

EISSN

1528-1159

Publication Date

May 15, 2013

Volume

38

Issue

11

Start / End Page

927 / 935

Location

United States

Related Subject Headings

  • White People
  • United States
  • Spinal Stenosis
  • Spinal Fusion
  • Retrospective Studies
  • Postoperative Complications
  • Outcome Assessment, Health Care
  • Orthopedics
  • Middle Aged
  • Medicaid
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lad, S. P., Bagley, J. H., Kenney, K. T., Ugiliweneza, B., Kong, M., Bagley, C. A., … Boakye, M. (2013). Racial disparities in outcomes of spinal surgery for lumbar stenosis. Spine (Phila Pa 1976), 38(11), 927–935. https://doi.org/10.1097/BRS.0b013e31828165f9
Lad, Shivanand P., Jacob H. Bagley, Krista T. Kenney, Beatrice Ugiliweneza, Maiying Kong, Carlos A. Bagley, Oren N. Gottfried, Robert E. Isaacs, Chirag G. Patil, and Maxwell Boakye. “Racial disparities in outcomes of spinal surgery for lumbar stenosis.Spine (Phila Pa 1976) 38, no. 11 (May 15, 2013): 927–35. https://doi.org/10.1097/BRS.0b013e31828165f9.
Lad SP, Bagley JH, Kenney KT, Ugiliweneza B, Kong M, Bagley CA, et al. Racial disparities in outcomes of spinal surgery for lumbar stenosis. Spine (Phila Pa 1976). 2013 May 15;38(11):927–35.
Lad, Shivanand P., et al. “Racial disparities in outcomes of spinal surgery for lumbar stenosis.Spine (Phila Pa 1976), vol. 38, no. 11, May 2013, pp. 927–35. Pubmed, doi:10.1097/BRS.0b013e31828165f9.
Lad SP, Bagley JH, Kenney KT, Ugiliweneza B, Kong M, Bagley CA, Gottfried ON, Isaacs RE, Patil CG, Boakye M. Racial disparities in outcomes of spinal surgery for lumbar stenosis. Spine (Phila Pa 1976). 2013 May 15;38(11):927–935.

Published In

Spine (Phila Pa 1976)

DOI

EISSN

1528-1159

Publication Date

May 15, 2013

Volume

38

Issue

11

Start / End Page

927 / 935

Location

United States

Related Subject Headings

  • White People
  • United States
  • Spinal Stenosis
  • Spinal Fusion
  • Retrospective Studies
  • Postoperative Complications
  • Outcome Assessment, Health Care
  • Orthopedics
  • Middle Aged
  • Medicaid