{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:02:49Z","timestamp":1787025769552,"version":"build-2736575974"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Race plays a salient role in access to surgical care. However, few investigations have assessed the impact of race within surgical populations after care has been delivered. The objective of this study was to employ an exact matching protocol to a homogenous population of spine surgery patients in order to isolate the relationships between race and short-term postoperative outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>In total, 4263 consecutive patients who underwent single-level, posterior-only lumbar fusion at a single multihospital academic medical center were retrospectively enrolled. Of these patients, 3406 patients self-identified as White and 857 patients self-identified as non-White. Outcomes were initially compared across all patients via logistic regression. Subsequently, White patients and non-White patients were exactly matched on the basis of key demographic and health characteristics (1520 matched patients). Outcome disparities were evaluated between the exact-matched cohorts. Primary outcomes were readmissions, emergency department (ED) visits, reoperations, mortality, intraoperative complications, and discharge disposition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Before matching, non-White patients were less likely to be discharged home and more likely to be readmitted, evaluated in the ED, and undergo reoperation. After matching, non-White patients experienced higher rates of nonhome discharge, readmissions, and ED visits. Non-White patients did not have more surgical complications either before or after matching.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Between otherwise similar cohorts of spinal fusion cases, non-White patients experienced unfavorable discharge disposition and higher risk of multiple adverse postoperative outcomes. However, these findings were not accounted for by differences in surgical complications, suggesting that structural factors underlie the observed disparities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2023.12.spine23700","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T12:55:12Z","timestamp":1713272112000},"page":"717-722","source":"Crossref","is-referenced-by-count":8,"title":["Racial disparities in short-term spinal fusion outcomes across 4263 consecutive patients"],"prefix":"10.3171","volume":"40","author":[{"given":"Austin J.","family":"Borja","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan S.","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritesh","family":"Karsalia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daksh","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emelia G.","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria A.","family":"Punchak","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianbo","family":"Na","sequence":"additional","affiliation":[{"name":"McKenna EpiLog Fellowship in Population Health, University of Pennsylvania, Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D.","family":"McClintock","sequence":"additional","affiliation":[{"name":"West Chester University, The West Chester Statistical Institute and Department of Mathematics, West Chester, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Schuster","sequence":"additional","affiliation":[{"name":"McKenna EpiLog Fellowship in Population Health, University of Pennsylvania, Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil R.","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia;"},{"name":"McKenna EpiLog Fellowship in Population Health, University of Pennsylvania, Philadelphia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Health Care Financ Rev","first-page":"75","article-title":"Understanding and addressing racial disparities in health care","volume":"21","author":"Williams DR","year":"2000","unstructured":"Williams DR, Rucker TD. 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National Academies Press; 2017.Accessed December 26, 2023.https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK425845\/"},{"issue":"3","key":"b4","series-title":"J Am Coll Surg","first-page":"482","article-title":"Racial disparities in surgical care and outcomes in the United States: a comprehensive review of patient, provider, and systemic factors","volume":"216","author":"Haider AH","year":"2013","unstructured":"Haider AH, Scott VK, Rehman KA,  Racial disparities in surgical care and outcomes in the United States: a comprehensive review of patient, provider, and systemic factors. J Am Coll Surg. 2013;216(3):482\u2013492.e12."},{"issue":"20","key":"b5","series-title":"Cancer","first-page":"4999","article-title":"Effect of race and socioeconomic status on surgical margins and biochemical outcomes in an equal-access health care setting: results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database","volume":"118","author":"Chu DI","year":"2012","unstructured":"Chu DI, Moreira DM, Gerber L,  Effect of race and socioeconomic status on surgical margins and biochemical outcomes in an equal-access health care setting: results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Cancer. 2012;118(20):4999\u20135007."},{"key":"b6","series-title":"World Neurosurg","first-page":"e175","article-title":"Racial and ethnic disparities in the inpatient management of primary spinal cord tumors","volume":"140","author":"Chiu RG","year":"2020","unstructured":"Chiu RG, Murphy BE, Zhu A, Mehta AI. Racial and ethnic disparities in the inpatient management of primary spinal cord tumors. World Neurosurg. 2020;140:e175\u2013e184."},{"key":"b7","series-title":"Clin Neurol Neurosurg","first-page":"106634","article-title":"Impact of race on outcomes and healthcare utilization following spinal fusion for adolescent idiopathic scoliosis","volume":"206","author":"Elsamadicy AA","year":"2021","unstructured":"Elsamadicy AA, Koo AB, David WB,  Impact of race on outcomes and healthcare utilization following spinal fusion for adolescent idiopathic scoliosis. Clin Neurol Neurosurg. 2021;206:106634."},{"issue":"4","key":"b8","series-title":"J Neurosurg Spine","first-page":"678","article-title":"Impact of race on nonroutine discharge, length of stay, and postoperative complications after surgery for spinal metastases","volume":"36","author":"Hung B","year":"2021","unstructured":"Hung B, Pennington Z, Hersh AM,  Impact of race on nonroutine discharge, length of stay, and postoperative complications after surgery for spinal metastases. J Neurosurg Spine. 2021;36(4):678\u2013685."},{"key":"b9","series-title":"N Am Spine Soc J","first-page":"100171","article-title":"Do racial disparities exist in a spine surgery practice that serves a predominately minority population? Outcomes of transforaminal lumbar interbody fusion: a retrospective review","volume":"12","author":"Volaski HA","year":"2022","unstructured":"Volaski HA, Sharfman ZT, Shah P, Eleswarapu A, Geller DS, Krystal J. Do racial disparities exist in a spine surgery practice that serves a predominately minority population? Outcomes of transforaminal lumbar interbody fusion: a retrospective review. N Am Spine Soc J. 2022;12:100171."},{"issue":"9","key":"b10","series-title":"Spine (Phila Pa 1976)","first-page":"E559","article-title":"Association between social determinants of health and postoperative outcomes in patients undergoing single-level lumbar fusions: a matched analysis","volume":"46","author":"Khalid SI","year":"2021","unstructured":"Khalid SI, Maasarani S, Nunna RS,  Association between social determinants of health and postoperative outcomes in patients undergoing single-level lumbar fusions: a matched analysis. 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Arch Surg. 2010;145(3):247\u2013253."},{"issue":"6","key":"b13","series-title":"Global Spine J","first-page":"583","article-title":"Racial disparities in surgical outcomes after spine surgery: an ACS-NSQIP analysis","volume":"9","author":"Sanford Z","year":"2019","unstructured":"Sanford Z, Taylor H, Fiorentino A,  Racial disparities in surgical outcomes after spine surgery: an ACS-NSQIP analysis. Global Spine J. 2019;9(6):583\u2013590."},{"issue":"2","key":"b14","series-title":"Global Spine J","first-page":"534","article-title":"Disparities in elective spine surgery for Medicaid beneficiaries: a systematic review","volume":"13","author":"Badin D","year":"2023","unstructured":"Badin D, Ortiz-Babilonia C, Musharbash FN, Jain A. Disparities in elective spine surgery for Medicaid beneficiaries: a systematic review. 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Curr Rev Musculoskelet Med. 2023;16(1):24\u201332."},{"key":"b17","series-title":"New Yorker","article-title":"Why doctors hate their computers","author":"Gawande A","unstructured":"Gawande A. Why doctors hate their computers. New Yorker. November 5, 2018. Accessed December 26, 2023. https:\/\/www.newyorker.com\/magazine\/2018\/11\/12\/why-doctors-hate-their-computers"},{"issue":"e232","key":"b18","series-title":"World Neurosurg","first-page":"e244","article-title":"Racial disparities in outcomes after spine surgery: a systematic review and meta-analysis","volume":"157","author":"Khan IS","year":"2022","unstructured":"Khan IS, Huang E, Maeder-York W,  Racial disparities in outcomes after spine surgery: a systematic review and meta-analysis. 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Spine J. 2019;19(1):41\u201349."},{"key":"b21","series-title":"StatPearls","article-title":"Laminectomy","author":"Estefan M","year":"2023","unstructured":"Estefan M, Munakomi S, Camino Willhuber GO. Laminectomy. In: StatPearls. StatPearls Publishing; 2023. Accessed December 26, 2023. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK542274\/"},{"issue":"7","key":"b22","series-title":"J Am Acad Orthop Surg","first-page":"e394","article-title":"Body mass index and risk of complications after posterior lumbar spine fusion: a matched cohort analysis investigating underweight and obese patients","volume":"31","author":"Alsoof D","year":"2023","unstructured":"Alsoof D, Johnson K, McDonald CL, Daniels AH, Cohen EM. Body mass index and risk of complications after posterior lumbar spine fusion: a matched cohort analysis investigating underweight and obese patients. J Am Acad Orthop Surg. 2023;31(7):e394\u2013e402."},{"key":"b23","series-title":"J Orthop Sci","article-title":"Risk factors for early reoperation in patients after posterior lumbar interbody fusion surgery. A propensity-matched cohort analysis","author":"Hikata T","unstructured":"Hikata T, Takahashi Y, Ishihara S,  Risk factors for early reoperation in patients after posterior lumbar interbody fusion surgery. A propensity-matched cohort analysis. J Orthop Sci. Published online December 21, 2022. doi:10.1016\/j.jos.2022.12.002"},{"issue":"7","key":"b24","series-title":"Clin Spine Surg","first-page":"E332","article-title":"Put down the tin: chewing tobacco use is associated with worse outcomes after primary lumbar fusion","volume":"36","author":"Cole MW","year":"2023","unstructured":"Cole MW, Collins LK, Waters TL, Salas Z, Sherman WF, Cyriac M. Put down the tin: chewing tobacco use is associated with worse outcomes after primary lumbar fusion. Clin Spine Surg. 2023;36(7):E332\u2013E338."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/40\/6\/article-p717.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/40\/6\/article-p717.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/40\/6\/article-p717.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T08:18:32Z","timestamp":1733473112000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/40\/6\/article-p717.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,1]]},"references-count":24,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2023.12.spine23700","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2024,6,1]]}}}