Disparities in anterior cervical discectomy and fusion provision and outcomes for cervical stenosis

作者：Ankita Das, Sima M. Vazquez, Alan L. Stein, Jacob D. Greisman, Christina Ng, Tiffany Ming, Grigori Vaserman, Eris Spirollari, Alexandria Naftchi, Jose F. Dominguez, Simon Hanft, John K. Houten, Merritt Drew Kinon · 发表于：North American Spine Society Journal (NASSJ) · 年份：2023 · DOI：10.1016/j.xnsj.2023.100217 · 被引用次数：12 · 研究领域：Cervical and Thoracic Myelopathy、Spine and Intervertebral Disc Pathology、Total Knee Arthroplasty Outcomes

Background: Disparities in neurosurgical care have emerged as an area of interest when considering the impact of social determinants on access to health care. Decompression via anterior cervical discectomy and fusion (ACDF) for cervical stenosis (CS) may prevent progression towards debilitating complications that may severely compromise one's quality of life. This retrospective database analysis aims to elucidate demographic and socioeconomic trends in ACDF provision and outcomes of CS-related pathologies. Methods: The Healthcare Cost and Utilization Project National Inpatient Sample database was queried between 2016 and 2019 using International Classification of Diseases 10th edition codes for patients undergoing ACDF as a treatment for spinal cord and nerve root compression. Baseline demographics and inpatient stay measures were analyzed. Results: Patients of White race were significantly less likely to present with manifestations of CS such as myelopathy, plegia, and bowel-bladder dysfunction. Meanwhile, Black patients and Hispanic patients were significantly more likely to experience these impairments representative of the more severe stages of the degenerative spine disease process. White race conferred a lesser risk of complications such as tracheostomy, pneumonia, and acute kidney injury in comparison to non-white race. Insurance by Medicaid and Medicare conferred significant risks in terms of more advanced disease prior to intervention and negative inpatient. Patients...