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Preoperative vitamin D deficiency common in patients undergoing spinal fusion
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CHICAGO — Researchers from St. Louis found an “alarmingly high” vitamin D abnormality rate in adults undergoing spinal fusion, according to a study presented here at the 2011 Annual Meeting of the North American Spine Society .
“The objectives of this study were to characterize the prevalence of preoperative hypovitaminosis D on adults undergoing spinal fusion — and to ascertain whether previously identified risk factors for deficiency could be applied to the spine population,” study author Jacob M. Buchowski, MD, said during his presentation.
Buchowski and his team measured serum 25-hydroxyvitamin D (25OHD) levels in 262 adult patients scheduled to undergo spinal fusion. For the purpose of the study, vitamin D deficiency was defined as a 25OHD level of less than 20 ng/ml. Preoperative Visual Analogue Scale (VAS), Neck Disability Index (NDI) and Oswestry Disability Index (ODI) scores were taken for each patient. The investigators compared the scores of patients who displayed vitamin D deficiency to those who displayed normal levels.
The mean vitamin D level among the cohort was 28.6 ng/ml, with inadequacy and deficiency rates of 65% and 27%, respectively.
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“Looking at the risk factors, patients who had vitamin D deficiency tended to be obese, they tended to be light-skinned and a large percentage of them were smokers,” Buckowski said. “Interestingly, patients with a history of revision surgery … or those with a history of fractures were not found to be statistically different from those who were not vitamin D deficient.”
Among those patients who had inadequate levels of vitamin D, Buchowski said, the patients had higher VAS pain scores, lower bone mineral density and a higher prevalence of neurologic deficits.
“Upping patient vitamin D levels through supplementation is safe, it is effective, it is inexpensive … and considering the financial and potential neurological burden of the aforementioned complications, we advocate it for patients with vitamin D deficiency,” Buchowski concluded.
Reference:
- Buchowski JM, Stoker G, Bridwell K, et al. Preoperative vitamin D status in adults undergoing spinal fusion. Paper #45. Presented at the 2011 Annual Meeting of the North American Spine Society. Nov. 2-5. Chicago.
- Disclosure: Buchowski is a consultant for Stryker and CoreLink. He also has speaking and/or teaching arrangements with Stryker.
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