Association between Vitamin D Deficiency and Outcomes Following Spinal Fusion Surgery: A Systematic Review

• Published in: World neurosurgery 2016-11, Vol.95, p.71-76
• Main Authors: Kerezoudis, Panagiotis, MD, Rinaldo, Lorenzo, MD, PhD, Drazin, Doniel, MD, Kallmes, David, MD, Krauss, William, MD, Hassoon, Ahmed, MD, MPH, Bydon, Mohamad, MD
• Format: Article
• Language: English
• Subjects: Back Pain - epidemiology; Humans; Neurosurgery; Osteomalacia; Patient Reported Outcome Measures; Postoperative Complications - epidemiology; Pseudarthrosis; Pseudarthrosis - epidemiology; Spinal Diseases - surgery; Spinal Fusion; Spinal surgery; Surgical outcomes; Treatment Outcome; Vitamin D deficiency; Vitamin D Deficiency - epidemiology
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2016.07.074

Abstract Objective Vitamin D deficiency has been found to be a relatively common occurrence in patients presenting for spinal surgery. Nevertheless, it remains unclear whether this abnormality has any effect on spinal fusion outcomes. We performed a systematic review of available literature relevant to the association between vitamin D deficiency and spinal fusion outcomes. Methods A systematic and critical review of recent literature was conducted using the PRISMA guidelines. The sources of the data were Pubmed, Google Scholar, Cochrane, Web of Science and Scopus. Key search terms were “vitamin D”, “spinal surgery outcomes”, “spinal fusion” and “pseudarthrosis”. Papers included in the review were original research articles in peer-reviewed journals. The articles were thoroughly examined and compared on the basis of study design, outcomes, and results. Results A total of 5 studies were included in the qualitative analysis. Patients presenting with vitamin D deficiency achieved lower fusion rates and suffered higher rates of recurrent-persistent low back pain as compared to patients with normal vitamin D levels. Studies examining the effect of postoperative vitamin D supplementation in deficient patients reported significant improvement in low back pain intensity, patient reported outcomes scores and fusion rates compared to baseline as well as to control groups. Conclusion Current literature suggests that patients presenting for spinal fusion may benefit from correction of vitamin D deficiency in order to maximize chances of a successful arthrodesis and to achieve optimal surgical outcomes. Future prospective studies are needed to determine whether routine preoperative treatment of this metabolic derangement is warranted.