Vitamin D Supplementation Improves the Effects of the Rehabilitation Program on Balance and Pressure Distribution in Patients after Anterior Cervical Interbody Fusion-Randomized Control Trial

Abstract

Study Design: A double-blinded, randomized controlled trial. Background: Surgery is effective in reducing pain intensity in patients with cervical disc disease. However, functional measurements demonstrated that the results have been not satisfactory enough. Thus, rehabilitation programs combined with the supplementation of vitamin D could play an essential role. Methods. The study recruited 30 patients, aged 20 to 70 years, selected for anterior cervical interbody fusion (ACIF). The patients were randomly divided into the placebo (Pl) and vitamin D (3200 IU D3/day) supplemented groups. The functional tests limits of stability (LOS), risk of falls (RFT), postural stability (PST), Romberg test, and foot pressure distribution were performed before supplementation (BS—week 0), five weeks after supplementation (AS—week 5), four weeks after surgery (BSVR—week 9), and 10 weeks after supervising rehabilitation (ASVR—week 19). Results. The concentration of 25(OH)D3 in the serum, after five weeks of supplementation, was significantly increased, while the Pl group maintained the same. The RFT was significantly reduced after five weeks of vitamin D supplementation. Moreover, a further significant decrease was observed following rehabilitation. In the Pl group, no changes in the RFT were observed. The overall postural stability index (OSI), LOS, and the outcomes of the Romberg test significantly improved in both groups; however, the effects on the OSI were more pronounced in the D3 group at the end of the rehabilitation program. Conclusions. Our data suggest that vitamin D supplementation positively affected the rehabilitation program in patients implemented four weeks after ACIF by reducing the risk of falls and improving postural stability.

Optimizing Perioperative Nutrition for Spine Surgery

“…Krasowska et al23 demonstrated reductions in subjective pain measured using the visual analog pain scale, and decreased inflammatory markers such as interleukin-6, CRP, and tumor necrosis factor-α after rehabilitation lasting around 10 weeks. Another double-blinded trial in anterior cervical interbody fusion patients found supplementation of vitamin D was associated with reduced fall risk, and improved stability 4 weeks after surgery 28. A placebo-controlled clinical trial noted similar improvements in reduction of fall risks with vitamin D supplementation in postmenopausal women after 9 months 29.…”

“…Another double-blinded trial in anterior cervical interbody fusion patients found supplementation of vitamin D was associated with reduced fall risk, and improved stability 4 weeks after surgery. 28 A placebo-controlled clinical trial noted similar improvements in reduction of fall risks with vitamin D supplementation in postmenopausal women after 9 months. 29 A retrospective review of insurance claims demonstrated that patients undergoing PLIF with vitamin D deficiency had an increased hardware failure rate of 3.3% compared with 2.6% and an increased revision rate of 4.3% versus 3.5%.…”