Start Date
2-2-2026 12:30 PM
End Date
2-2-2026 1:30 PM
Description
Introduction: Rural communities have limited spine surgery care, which disproportionately affects older adults. Research has evaluated how hospital location affects patient outcomes; however, minimal work has investigated the impact of home location. This work’s purpose was evaluating the impact of patient geographical classification (rural/suburban/urban) on lumbar fusion outcomes.
Methods: Adult patients who underwent elective lumbar fusion (2017-2022) at a single tertiary center were identified via Structured Query Language search. Patient demographic/surgical characteristics, surgical outcomes, and patient-reported outcome measures (PROMs) were collected. Rural/urban/suburban was assigned by zip code.
Results: 461 patients were included (11.9% urban [U], 78.3% suburban [S], 9.8% rural [R]). Rural patients lived further from the hospital (U—14.6 vs. S—40.5 vs. R—104 miles; p< 0.001), experienced greater time between first appointment to surgery (U—9.66 vs. S—15.0 vs. R—18.8 months; p=0.029), used opioids at a higher rate (U—23.6% vs. S—26.6% vs. R—46.7%; p=0.014) and consumed more morphine milligram equivalents (U—48.8 vs. S—65.7 vs. R—131; p=0.011) at 90-365 days postoperatively. Rural patients experienced the least improvement in Oswestry Disability Index (ODI) at 6 months (U:-16.77 vs. S:-21.29 vs. R:-12.96; p=0.024) and 1 year (U:-19.79 vs. S:-21.76 vs. R:-12.43; p=0.043).
Conclusion: Bivariate analysis indicated that rural geographical designation was associated with decreased disability improvement and increased opioid use after lumbar fusion.
Included in
Patient Geographical Area as a Risk Factor for Postoperative Outcomes Following Lumbar Fusion Surgery
Introduction: Rural communities have limited spine surgery care, which disproportionately affects older adults. Research has evaluated how hospital location affects patient outcomes; however, minimal work has investigated the impact of home location. This work’s purpose was evaluating the impact of patient geographical classification (rural/suburban/urban) on lumbar fusion outcomes.
Methods: Adult patients who underwent elective lumbar fusion (2017-2022) at a single tertiary center were identified via Structured Query Language search. Patient demographic/surgical characteristics, surgical outcomes, and patient-reported outcome measures (PROMs) were collected. Rural/urban/suburban was assigned by zip code.
Results: 461 patients were included (11.9% urban [U], 78.3% suburban [S], 9.8% rural [R]). Rural patients lived further from the hospital (U—14.6 vs. S—40.5 vs. R—104 miles; p< 0.001), experienced greater time between first appointment to surgery (U—9.66 vs. S—15.0 vs. R—18.8 months; p=0.029), used opioids at a higher rate (U—23.6% vs. S—26.6% vs. R—46.7%; p=0.014) and consumed more morphine milligram equivalents (U—48.8 vs. S—65.7 vs. R—131; p=0.011) at 90-365 days postoperatively. Rural patients experienced the least improvement in Oswestry Disability Index (ODI) at 6 months (U:-16.77 vs. S:-21.29 vs. R:-12.96; p=0.024) and 1 year (U:-19.79 vs. S:-21.76 vs. R:-12.43; p=0.043).
Conclusion: Bivariate analysis indicated that rural geographical designation was associated with decreased disability improvement and increased opioid use after lumbar fusion.
