Spine surgeons routinely treat cervical radiculopathy (CR) with surgical options, including anterior cervical diskectomy and fusion (ACDF) and cervical disk replacement (CDR). The US FDA authorized CDR in 2007 as a motion-saving alternative to ACDF. CDR usage has expanded as data confirming its long-term benefit has emerged. Despite the effectiveness of CDR, research has revealed that socioeconomic considerations may determine which patients get CDR versus ACDF. For a study, researchers sought to determine if there were any gender, racial, or ethnic inequalities in the use of CDR versus ACDF for CR.
The Vizient Clinical Database contained information on 18-year-old patients with elective CDR or ACDF for CR between 2017 and 2020. The proportions of CDR and ACDF patients and their comorbidities, complications, and outcomes were compared by gender, race, and ethnicity. For multiple comparisons, the Bonferroni correction was used.
A total of 7,384 patients were evaluated, with 1,427 receiving CDR and 5,957 getting ACDF. Black patients receiving CR surgery were less likely to have CDR than ACDF, had a longer stay, and had higher readmission rates, whereas Hispanic patients had greater complication rates than non-Hispanic patients.
There are significant racial and ethnic differences in CR therapy. Therefore, interventions to reduce obstacles to spine care, such as underinsurance and unconscious prejudice, are required.
Reference: journals.lww.com/jaaos/Abstract/2022/07150/Gender,_Racial,_and_Ethnic_Differences_in_the.12.aspx