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