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Our study demonstrated significant racial and health insurance–based disparities in the use of spinal augmentation for the treatmentof osteoporotic vertebral fracture. Compared with whitepatients, all racial and ethnic minority groups had significantlylower rates of inpatient spine augmentation. Indeed, less thanone-half of black patients admitted with a primary diagnosis ofvertebral fracture were treated with spine augmentation, whilenearly two-thirds of white patients underwent spine augmentation.Differences in spine augmentation use among Hispanic andAsian/Pacific Islander patients compared with white patients werealso statistically significant, but the degree of difference was muchless marked than that seen in black-versus-white patients. Conversely,when implemented, the type of augmentation used, eitherkypho- or vertebroplasty, was quite similar among racial groups.Despite the large sample size in our study, there is significantunder-representation of patients who were not white as black patientscomposed only 2.7%, Hispanic patients composed 4.1%,and Asian/Pacific Islander patients composed 1.9% of the samplesize. The reason for this difference is unclear and may be multifactorial,including lower fracture rates for black, Hispanic, andAsian women compared with white women8 and disparities inosteoporosis treatment in these minority groups.
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