The effect of patient race on extent of functional improvement after cervical spine surgery

Aladine Elsamadicy, Owoicho Adogwa, Elizabeth Reiser, Parastou Fatemi, Joseph Cheng, Carlos Bagley

Research output: Contribution to journalArticle

5 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)822-826
Number of pages5
JournalSpine
Volume41
Issue number9
DOIs
StatePublished - Jan 1 2016

Fingerprint

Spine
Diskectomy
Pain Measurement
Neck
Neck Pain
Longitudinal Studies
Cohort Studies
Demography
Incidence
Health
Wounds and Injuries
Patient Reported Outcome Measures

Keywords

  • ACDF
  • Cervical spine
  • Disparity
  • Mental component score
  • Neck disability index
  • Physical component score
  • Race
  • Spine surgery
  • Surgical outcomes
  • Visual analog score

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

The effect of patient race on extent of functional improvement after cervical spine surgery. / Elsamadicy, Aladine; Adogwa, Owoicho; Reiser, Elizabeth; Fatemi, Parastou; Cheng, Joseph; Bagley, Carlos.

In: Spine, Vol. 41, No. 9, 01.01.2016, p. 822-826.

Research output: Contribution to journalArticle

Elsamadicy, Aladine ; Adogwa, Owoicho ; Reiser, Elizabeth ; Fatemi, Parastou ; Cheng, Joseph ; Bagley, Carlos. / The effect of patient race on extent of functional improvement after cervical spine surgery. In: Spine. 2016 ; Vol. 41, No. 9. pp. 822-826.
@article{4beecafabb8143928b870f0fecec79cc,
title = "The effect of patient race on extent of functional improvement after cervical spine surgery",
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.",
keywords = "ACDF, Cervical spine, Disparity, Mental component score, Neck disability index, Physical component score, Race, Spine surgery, Surgical outcomes, Visual analog score",
author = "Aladine Elsamadicy and Owoicho Adogwa and Elizabeth Reiser and Parastou Fatemi and Joseph Cheng and Carlos Bagley",
year = "2016",
month = "1",
day = "1",
doi = "10.1097/BRS.0000000000001346",
language = "English (US)",
volume = "41",
pages = "822--826",
journal = "Spine",
issn = "0362-2436",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

TY - JOUR

T1 - The effect of patient race on extent of functional improvement after cervical spine surgery

AU - Elsamadicy, Aladine

AU - Adogwa, Owoicho

AU - Reiser, Elizabeth

AU - Fatemi, Parastou

AU - Cheng, Joseph

AU - Bagley, Carlos

PY - 2016/1/1

Y1 - 2016/1/1

N2 - 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.

AB - 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.

KW - ACDF

KW - Cervical spine

KW - Disparity

KW - Mental component score

KW - Neck disability index

KW - Physical component score

KW - Race

KW - Spine surgery

KW - Surgical outcomes

KW - Visual analog score

UR - http://www.scopus.com/inward/record.url?scp=84969513487&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84969513487&partnerID=8YFLogxK

U2 - 10.1097/BRS.0000000000001346

DO - 10.1097/BRS.0000000000001346

M3 - Article

C2 - 27128256

AN - SCOPUS:84969513487

VL - 41

SP - 822

EP - 826

JO - Spine

JF - Spine

SN - 0362-2436

IS - 9

ER -