Is There a Correlation Between Preoperative or Postoperative Vitamin D Levels with Pseudarthrosis, Hardware Failure, and Revisions After Lumbar Spine Fusion?

Donnally, Chester J.; Sheu, Jonathan; Bondar, Kevin; Mouhanna, Joelle; Li, Deborah J.; Butler, Alexander J.; Rush, A. John; Gjolaj, Joseph P.

doi:10.1016/j.wneu.2019.06.109

Cited by 14 publications

(16 citation statements)

References 36 publications

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“…Finally, 7 articles remained for analysis according to our defined inclusion criteria. 2,5,[10][11][12][13] Figure 1 demonstrates the systematic search and exclusion protocol.…”

Section: Search Resultsmentioning

confidence: 99%

“…6,13,20, 21 Donnally et al found no significant correlation between the pre-and postoperative vitamin D levels and rates of pseudarthrosis or revision surgery after the lumbar spinal fusion surgery. 13 On the contrary, Ravindra et al showed a significantly longer time to fusion in patients with vitamin D deficiency who underwent elective spinal fusion. 6 They also performed a multivariate logistic regression, which was controlled for many possible confounding variables, and found that vitamin D deficiency is an independent predictor of pseudarthrosis within a period of 12 months.…”

Section: Discussionmentioning

confidence: 98%

“…The total sample size was 1188 participants and studies published from 2012 to 2020. Four of these studies were conducted in the United States, 2,5,12,13 and 3 other studies in Brazil, 11 Korea, 10 and China. 14 Duration of the studies included ranged from 12 to 24 months.…”

Section: Study Characteristicsmentioning

confidence: 99%

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The Effect of Vitamin D Deficiency on Outcomes of Patients Undergoing Elective Spinal Fusion Surgery: A Systematic Review and Meta-Analysis

et al. 2022

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Objectives: Vitamin D plays a major role in bone metabolism, regulating calcium and phosphorus homeostasis, along with bone growth and remodeling processes. The objective of the present study was to assess the effect of vitamin D deficiency on clinical outcomes following elective spinal fusion surgery by conducting a meta-analysis on the relevant literature.Methods: Studies included in this analysis involved patients older than 18 years who underwent elective spinal fusion surgery. The number of patients as well as visual analog scale (VAS) and Oswestry Disability Index (ODI) in groups with and without vitamin D deficiency were required to be reported in eligible studies. Of the 179 articles identified, 7 met the inclusion criteria and were included in the analysis.Results: Seven studies, including 1188 patients, reported the relationship between vitamin D deficiency and clinical outcomes in patients undergoing elective spinal fusion surgery. Five studies reported VAS as a primary outcome. The combined results using a random-effects model showed reduction in VAS after elective spinal fusion surgery in group with vitamin D deficiency, but no statistically significant association was identified between vitamin D deficiency and VAS. ODI was assessed and reported as an outcome measure in 5 of the included studies. The combined results showed an increase in ODI following elective spinal fusion surgery in the vitamin D-deficient group compared to the group with normal levels of vitamin D. In addition, a significant association was observed between ODI and vitamin D deficiency.Conclusions: Vitamin D deficiency may negatively affect the postoperative outcomes in elective spinal fusion surgery. Preoperative optimization of vitamin D levels would seem appropriate. Future high-quality studies are highly warranted to evaluate this.Clinical Relevance: This meta-analysis demonstrated a significant association between vitamin D deficiency and postoperative ODI scores in patients undergoing elective spinal fusion surgery.

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“…Finally, 7 articles remained for analysis according to our defined inclusion criteria. 2,5,[10][11][12][13] Figure 1 demonstrates the systematic search and exclusion protocol.…”

Section: Search Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

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The Effect of Vitamin D Deficiency on Outcomes of Patients Undergoing Elective Spinal Fusion Surgery: A Systematic Review and Meta-Analysis

et al. 2022

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“…Other retrospective and case series studies over the past 3 decades have also investigated vitamin D levels in the setting of spine surgery. 43,51,55,61 Whereas Schofferman et al 61 and Donnally et al 55 observed no statistically significant association between vitamin D levels and pseudarthrosis, other studies have indicated that increased vitamin D levels correlated with improved outcomes. 43,51 Waikakul et al 43 studied lumbar fusion patients who had been given 600 IU/d of vitamin D for 10 days (or until their levels normalized).…”

Section: Background and Clinical Studymentioning

confidence: 99%

“…Although some contend that the connection between degenerative spinal diseases and poor outcomes results from vitamin D deficiency, several more recent studies found no association. 55,56 Also potentially relevant in the care of possible spine surgery patients, vitamin D appears to affect bonefracture healing. Lower vitamin D levels have been observed to correlate with lower bone densities, delayed rate of fracture healing, and screw loosening among patients who have undergone spine surgery.…”

Section: Background and Clinical Studymentioning

confidence: 99%

A Review of Vitamin D in Spinal Surgery: Deficiency Screening, Treatment, and Outcomes

et al. 2020

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In this review, we discuss the demonstrated value of vitamin D in bone maintenance, fracture resistance, spinal health, and spine surgery outcomes. Despite this, the effect of vitamin D levels in spine surgery has not been well described. Through this review of literature, several conclusions were drawn. First, despite the fact that a high number of spine surgery patients are vitamin D deficient, screening is not commonly performed. Second, adequate vitamin D levels will not be achieved in a majority of these patients without supplementation. Last, inadequate vitamin D levels may increase the risk of pseudarthrosis. Given these findings, we suggest that many patients undergoing spinal surgery could be treated with vitamin D supplementation prior to surgery without the need for confirmatory testing for vitamin D deficiency. This is a more cost-effective method than screening all patients. However, future randomized trials and cost-effectiveness analyses are needed to determine the ultimate effects of vitamin D supplementation on clinical morbidity and surgical outcomes.

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The Role of Preoperative Vitamin D in Spine Surgery

Bajaj

Shah

Goodwin

et al. 2022

Curr Rev Musculoskelet Med

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Is There a Correlation Between Preoperative or Postoperative Vitamin D Levels with Pseudarthrosis, Hardware Failure, and Revisions After Lumbar Spine Fusion?

Cited by 14 publications

References 36 publications

The Effect of Vitamin D Deficiency on Outcomes of Patients Undergoing Elective Spinal Fusion Surgery: A Systematic Review and Meta-Analysis

The Effect of Vitamin D Deficiency on Outcomes of Patients Undergoing Elective Spinal Fusion Surgery: A Systematic Review and Meta-Analysis

A Review of Vitamin D in Spinal Surgery: Deficiency Screening, Treatment, and Outcomes

The Role of Preoperative Vitamin D in Spine Surgery

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