Role of Vitamin D and a Healthy Spine

Role of Vitamin D and a Healthy Spine

Role of Vitamin D and a Healthy Spine

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Association between low levels of Vitamin D and spinal surgery outcomes

The role of Vitamin D in maintaining a healthy spine has been underestimated and overlooked by many. In the last few years, the relationship between Vitamin D levels and various components of spine health have been reported on with increasing frequency within the literature. In short, Vitamin D acts as hormone and serves many functions. One of its main functions is to promote calcium regulation in the formation of new bone. Additionally, Vitamin D appears to have a protective effect on the immune and neurologic systems, reduces systemic inflammation and is involved in cellular growth.

In a previous blog, we have reported on the association of low levels of Vitamin D and the presence of back pain. Many patients elect to undergo spine surgery as a means of trying to alleviate their chronic back pain. A study presented this week at the American Association of Neurological Surgeons (AANS) annual meeting looked at the relationship between low levels of Vitamin D and outcomes from lumbar fusion. The study conducted at the University of Utah studied 133 adult patients who underwent a fusion for spondylosis (spinal osteoarthritis) during a 13 month period. Surgery included cervical, thoracic, and lumbar fusions. Vitamin D levels were measured in each patient prior to undergoing surgery. The researchers labeled a Vitamin D level (25 Hydroxy) of less than 30 ng/mL as “insufficient” and levels below 20 ng/mL as “deficient”. Most laboratories define a normal range of Vitamin D between 30 ng/mL and 80 ng/mL. Some practitioners recommend levels of at least 50 ng/mL.

In this study, the average patient had a Vitamin D level of 27.8 ng/mL. The study analysis revealed a nonunion (failure of the bones to unite) was associated with Vitamin D deficiency at a rate of 28%. For patients who were not Vitamin D deficient, the rate of nonunion was 12%. In regards to how long it took to achieve fusion, those with a vitamin D deficiency took an average of 11.8 months to fuse while those with a Vitamin D level that was within the normal range took only 8 months. The analysis did control for age, sex, type of fusion, length of fusion, and type of bone graft used. Vitamin D was shown to be an independent predictor of nonunion.

This is one of the first studies to investigate the relationship between Vitamin D levels and outcome in spinal surgery. A previously published study by Stoker et al (2013) looked at Vitamin D levels in 313 patients who underwent spine surgery. Fifty-seven (57%) percent of patients had insufficient levels of Vitamin D while 27% were Vitamin D deficient. While the analysis of that study did not look at the effect of low Vitamin D levels on outcome from surgery, the authors did express concern for the high percentage of patient with low levels of Vitamin D and the potential effect on outcome. Ravindra VM et al. Vitamin D deficiency may be associated with higher nonunion rates for spondylosis. Presented at: American Association of Neurological Surgeons Annual Meeting. May 2 – 6, 2015. Washington, D.C. Stoker GE at al. Preoperative vitamin D status of adults undergoing spinal fusion. Spine. 2013 Mar 15;38(6): 507-515.

Citations

  • Ravindra VM, Godzik J, Guan J, Dailey AT, Schmidt MH, Bisson EF, Hood RS, Ray WZ. Prevalence of Vitamin D Deficiency in Patients Undergoing Elective Spine Surgery: A Cross-Sectional Analysis. World Neurosurg. 2015 Jun;83(6):1114-9. PubMed PMID: 25535064

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Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
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