Secondary spinal fracture risk among patients residing in medically vulnerable areas: A population-wide study

This study examined regional healthcare disparities' impact on the secondary fracture risk following spinal fractures, the likeliest secondary fracture types, and associated risk factors. Participants were selected from the Korean National Health Insurance Service Sample Cohort. Secondary fractures were hip, wrist, humerus, spine, ankle, and pelvis fractures six months after the spinal fracture. The medically vulnerable regions were defined using the PARC index. A Cox proportional hazards model was used to examine differences in the secondary fracture. A total of 1,135 and 2,426 of the participants lived in medically severely-vulnerable and moderately-vulnerable regions, respectively. Among patients who had spinal fractures, those residing in severely-vulnerable areas had 1.16 times higher risk of secondary fractures compared to those residing in medically non-vulnerable areas. Within 25-84 months after spinal surgery, patients in severely-vulnerable regions had 1.28 times higher secondary fracture risk. Among patients with spinal fractures, those residing in medically vulnerable areas have a higher secondary fracture risk than those living in non-vulnerable areas. Policy measures are crucial for preventing secondary fractures in this population.