• Emmanuella Oduguwa, Faraaz Azam, Abigail Jenkins, Michael Farid, Jason Wang, Alejandra Possu, Jonathan Tao, Emmanuel Adeyemo, Paula Mofor, Yves Jordan Kenfack, Kristen Hall, Umaru Barrie, Salah G Aoun, and Carlos A Bagley.
• Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA. Electronic address: ellaoduguwa@gmail.com.
• World Neurosurg. 2024 Oct 1; 190: e648e664e648-e664.

ObjectiveThe influence of social determinants of health on health disparities is substantial. However, their impact on postsurgical outcomes in spine can be challenging to ascertain at the community level. This study aims to explore the interplay between presurgical attitudes, area deprivation index (ADI), income, employment status, and body mass index (BMI) on postsurgical outcomes at 3, 6, 9, and 12 months after elective spine surgery.MethodsThe study involved 127 patients who underwent elective spine surgery between August 2021 and August 2022 at a large academic institution. The main objective involved a prospective analysis of presurgical attitudes, coupled with a retrospective assessment of ADI, income, employment status, and BMI over 3, 6, 9, and 12 months following elective spine surgery using a univariate analysis.ResultsUtilizing the univariate analyses, ADI displayed a significant correlation with increased Patient-Reported Outcomes Measurement Information System and Visual Analog Scale scores both before surgery and at the 3-, 6-, and 9-month postsurgical intervals (P < 0.05). One year after surgery, patients in the lowest income group (annual income under $25,000) consistently demonstrated the highest Patient-Reported Outcomes Measurement Information System pain (8.00, P = 0.022). Patients who were not employed had significantly lower levels of social support (P = 0.042) and confidence in the health care system (P = 0.009). Individuals who were unemployed were most likely to be readmitted six weeks after surgery (P < 0.001).ConclusionsPresurgical attitudes, ADI, income, employment status, and BMI were important factors associated with improved surgical outcome measurements, indicating potential focal points for combating health disparities in spinal surgery patients.Copyright © 2024 Elsevier Inc. All rights reserved.

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