Disparities Exist in Kyphoplasty Treatment for Black and Lower-Income Medicare Recipients

Kyphosis, an exaggerated curve in the spine associated with vertebral fractures, causes stiffness and pain from spinal impingement. Kyphoplasty is a surgical procedure in which bone cement is injected into fractured vertebra to restore the spine to its correct height and angle. A large and growing body of literature supports the use of kyphoplasty to manage chronic pain associated with this condition, even in older populations. A new study examined trends in kyphoplasty among Medicare and Medicaid recipients with compression fractures to investigate racial and socioeconomic disparities in this patient population.

Frank Chen, Mark Jones, Joseph Manzi, Ethan Brovman, Nikhilesh Rao, Stephanie Vanterpool, and Richard Urman of Pain Medicine of the South, Knoxville, TN, received a Resident/Fellow Travel Award from the American Society of Regional Anesthesia and Pain Medicine (ASRA) for its 20th Annual Pain Medicine Meeting, being held November 18-20, 2021. The authors will present Abstract #2229, “Racial and Socioeconomic Disparities in Kyphoplasty Among the Medicare Population,” on Friday, November 19.

Chen et al. identified 215,495 patients who had vertebral compression fractures from 2016 to 2019 using a limited data set from the Center for Medicare and Medicaid Services. The average age was 75 years, with a majority being female (64.2%) and White (72.9%). Of all patients who had vertebral compression fractures, only 717 received kyphoplasty treatment. When analyzing for race and socioeconomic status, Chen et al. found kyphoplasty was less likely to be performed in Black patients, as well as in patients with dual Medicare and Medicaid eligibility, who tend to be lower-income older adults. In addition, patients with a past medical history of anxiety and nicotine dependence were more likely to have a kyphoplasty procedure.

“Taken together, we find that racial and socioeconomic disparities exist in the utilization of kyphoplasty among the Medicare and Medicaid population,” Chen et al. said. “While the causes of these differences may be multifactorial, we propose that further work is required to elucidate the complex etiology underlying these findings.”

ASRA is a professional member organization of more than 5,000 physicians and healthcare providers across the United States and the world. The vision of ASRA is to relieve the global burden of pain. ASRA is dedicated to advancing the science and practice of regional anesthesia and pain medicine to improve patient outcomes through research, education, and advocacy. Learn more at www.asra.com.