Correlation of Survival Time Following Surgery for Spinal Metastases with Race, Sex, and Socioeconomic Status: Analysis of a Single Institution Database

Introduction: Surgical intervention for spinal metastasis is often crucial in preventing disease progression. However, social factors affecting survivability remain understudied. This study investigates survivability following surgical treatment for spinal metastasis, focusing on demographic and socioeconomic factors.

Methods: Single institution radiology reports from January 2017- December 2021 were queried for spinal metastases. Demographic factors, Area Deprivation Index (ADI) for each patient's home address, primary cancer type, treatment data, time to treatment, and time of death were obtained for each patient, as applicable. Variables were analyzed using descriptive statistics and comparisons were performed using coefficient of determination analysis or one-way analysis of variance (ANOVA) (p < 0.05).

Results: Initial query resulted in 986 patients with complete treatment information, of whom 119 (12.07%) received spine surgery as a treatment modality. Of those receiving spine surgery, 60 patients (6.09%) also had complete data indicating date of expiration; the average survival time from spine surgery until date of expiration was 441.12 days (SD: 498.56). The average survival time for patients identifying as White or Caucasian was 317.52 days (SD: 344.55), while the average for Black or African American patients was 478.5 (SD: 617.73) and the average for Asian patients was 578.67 (SD: 156.92); no statistical differences in survivability were observed between races (p=0.21). Examining gender, the average survival times were 393 (SD: 396.26) and 508.48 (SD: 616.85) days for men and women, respectively; no statistical differences were observed between sexes (p=0.42). Finally, correlation of survivability with patients’ ADI indicated no relationship (R-squared=0.0012).

Conclusion : Analysis of a single-institution database of spinal metastases found that survivability after spine surgery did not differ significantly between patients of different races, sexes, or socioeconomic levels. Further investigation and analysis are warranted to assess the effects of such social factors on survivability following spine surgery.