• Nicholas M B Laskay, Yifei Sun, Evan G Gross, Mohammad A Hamo, Sasha Howell, James Mooney, and Jakub Godzik.
• Department of Neurosurgery, University of Alabama at Birmingham; Birmingham, AL.
• Spine. 2025 Jan 29.

Study DesignRetrospective Cohort Study.ObjectivesTo examine the impact of neighborhood-level socioeconomic factors on the delay of care and severity of disease among DCM patients at initial presentation.Summary Of Background DataDegenerative Cervical Myelopathy (DCM) is the most common etiology for spinal cord dysfunction among adults worldwide. Previous literature has suggested that social determinants of health including neighborhood-level socioeconomic status such as Area of Deprivation Index (ADI) may impact spine surgery outcomes in DCM.MethodsWe performed a single-institution retrospective analysis of all patients undergoing spine surgery for the treatment of DCM from 2010 to 2022. Patients were identified using CPT and ICD9/10 codes. Data was collected via review of the electronic medical record. ADI was extracted from patients addresses. Multivariate and univariate analysis was used to assess the relationship between socioeconomic variables and myelopathy characteristics.ResultsA total of 490 patients (Mean age: 60.3±11.3 y) were identified. Residence in rural areas was associated with higher Nurick score (OR 2.48,P=0.011), and lower mJOA score (OR 2.51, P=0.014) at presentation, and longer times to presentation (HR 0.48, P=0.003). Having high ADI was independently associated with shorter times to presentation (HR 1.46,P<0.001), but predicted higher Nurick score (OR 1.6, P=0.021) and lower mJOA score (OR 1.86,P=0.002). Unemployment was associated with longer times to presentation (HR 0.66,P<0.001), higher Nurick score (OR 4.5,P<0.001), and lower mJOA score (OR 4.51, P<0.001), while race was not.ConclusionsThis is the first single institution study investigating the influence of neighborhood-level measures such as ADI on presentation status and disease burden in patients with DCM. High ADI predicts shorter disease duration but more severe DCM symptoms. Rural residence, unemployment, and non-private insurance were independently associated with prolonged and more severe DCM symptoms while race was not.Level Of Evidence3.Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.

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