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

• Published in: International journal of spine surgery 2020-06, Vol.14 (3), p.447-454
• Main Authors: MAYO, BENJAMIN C., MASSEL, DUSTIN H., YACOB, ALEM, NARAIN, ANKUR S., HIJJI, FADY Y., JENKINS, NATHANIEL W., PARRISH, JAMES M., MODI, KRISHNA D., LONG, WILLIAM W., HRYNEWYCZ, NADIA M., BRUNDAGE, THOMAS S., SINGH, KERN
• Format: Article
• Language: English
• Subjects: Other & Special Categories
• ISSN: 2211-4599; 2211-4599
• DOI: 10.14444/7059

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.