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Health care systems have augmented the role that patients have in their care through the adoption of patient portals like MyChart. Studies across subspecialties have shown that these portals are associated with improved clinical outcomes. The purpose of this study was to compare clinical outcomes between patient portal users and non-users specifically in the surgical spine patient population. A retrospective clinical outcome analysis in adult spine patients at Duke University Medical Center between January 1, 2019, and June 30, 2021 was performed. The association between patient portal utilization and clinical outcomes was assessed using multivariable generalized linear mixed effects models including covariates for social risk variables (age, employment status, language, sex, marital status, race, ethnicity, insurance type and urbanicity of residence). Outcomes measured were 30-day readmission, 30-day return to the emergency room, discharge to places other than home, and length of hospital stay during procedure. Fixed effects estimates (odds ratios for binary outcomes and rate ratios for continuous outcomes) and 95% confidence intervals were reported. Patients who did not use the patient portal had higher odds of 30-day readmission (OR: 1.59; 95% CI: 1.26, 2.00), being discharged somewhere other than home (OR: 2.41, 95% CI: 1.95, 2.99), and had 1.21 times the length of stay compared to those who utilized the patient portal at the time of the procedure (Rate Ratio: 1.21; 95% CI: 1.12, 1.30). The difference in 30-day return to Emergency department rate was not statistically different between those who did and did not utilize the patient portal (OR: 1.10; 95% CI; 0.92,1.32) Our analysis of the association between patient portal utilization and clinical outcomes revealed that patients who use patient portals may have better clinical outcomes. Although additional studies need to be done to understand the underlying drivers of this association, this study is a promising preliminary look and may inform us of the value of patient portals in improving patient care. Additionally, it stresses the importance of identifying gaps in patient portal uptake as their use has been shown to positively impact health outcomes. This abstract does not discuss or include any applicable devices or drugs. [ABSTRACT FROM AUTHOR]