Black Patients More Likely Than White Patients to Suffer Negative Outcomes After Spine Surgery

By: Jessica George, Class of 2024

Figure 1: Disparities in healthcare outcomes may be due to systemic biases in healthcare delivery

Racial disparities in healthcare outcomes have been well-documented in numerous studies, including those focused on surgical procedures. Despite advances in surgical techniques and technologies, disparities in surgical outcomes persist, with some racial and ethnic groups experiencing worse outcomes than others. Understanding the factors that contribute to these disparities is crucial for ensuring equitable access to high-quality surgical care for all patients. Dr. Imad S. Khan and colleagues from Dartmouth-Hitchcock Medical Center conducted a systematic review and meta-analysis of existing research on racial disparities in outcomes after spine surgery. The study aimed to examine the prevalence and extent of racial disparities in spine surgery outcomes and identify factors that may contribute to these disparities.

After analyzing the outcomes of spine surgery on 3,501,830 patients from 20 cohort studies, the study found that Black patients experience significantly worse outcomes compared to White patients. The analysis showed that Black patients had a 55% higher risk of death, longer hospital stays (mean difference of 0.93 days), non-home discharge, and 30-day readmission compared to white patients. However, there were no significant differences in complication or reoperation rates. 

The study suggests that these disparities may be due to systemic biases in healthcare delivery. For example, Black patients may be less likely to receive appropriate pain management, diagnostic testing, or referrals for specialized care, leading to delayed diagnoses and treatments. Furthermore, racial biases and stereotypes among healthcare providers may contribute to lower quality of care and worse outcomes for Black patients.

It is worth noting that this study has some limitations. For instance, the study only included studies that were published in English, which may have led to the exclusion of relevant studies in other languages. Additionally, the study only included studies that reported outcomes for Black and White patients, which may have excluded studies that reported outcomes for other racial and ethnic groups. Finally, the study did not examine the impact of socioeconomic status on spine surgery outcomes, which may also contribute to racial disparities in healthcare.

The research conducted by Dr. Khan and colleagues provides compelling evidence of significant racial disparities in spine surgery outcomes. The study highlights the need for healthcare providers, policymakers, and researchers to work together to address and eliminate these disparities and ensure that all patients receive equitable care.


  1. I.S. Khan, et al., Racial disparities in outcomes after spine surgery: a systematic review and meta-analysis. World Neurosurgery 157, e232-e244 (2022). doi: 10.1016/j.wneu.2021.09.140. 
  2. Image retrieved from:

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