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Vitamin D status in cervical spondylotic myelopathy: comparison of fusion rates and patient outcome measures.

Abstract：

BACKGROUND:Patients undergoing elective spinal fusion have an alarming rate of vitamin D deficiency, but its impact on bone fusion and patient outcomes is unclear. We investigated the association of perioperative vitamin D levels, fusion rates, and patient-reported outcome in patients undergoing spinal fusion for cervical spondylotic myelopathy. METHODS:In this one-year, prospective, single-center observational study, serum 25-OH vitamin D levels were measured perioperatively in adult patients. Serum vitamin D levels <30 ng/mL were considered abnormal. The primary outcome measures were postoperative patient-reported outcomes (Neck Disability Index, Visual Analog Scale, EuroQol EQ-5D-3L, EQ-VAS). Secondary outcome measures were the presence of and time to solid bony fusion, controlling for Body Mass Index (BMI), age, and number of motion segments. RESULTS:Forty-one of 58 patients (71%) had laboratory-confirmed abnormal vitamin D levels. Patients with low vitamin D were younger (P<0.05) and had a higher BMI (P<0.05) than patients with adequate vitamin D, but the groups were otherwise similar. There were no differences in mean time to fusion between the two groups, but patients with low vitamin D reported more postoperative disability (P<0.05). Multivariate model analysis demonstrated an independent, significant association between normal vitamin D and lower postoperative neck disability index (P=0.05) and EQ-5D-3L (P=0.03). CONCLUSIONS:Vitamin D deficiency (<30 ng/mL) is highly prevalent in patients undergoing elective spinal fusion for cervical myelopathy. Low vitamin D levels were associated with worse patient-reported outcomes and were an independent predictor of greater disability, which suggests vitamin D supplementation may offer some benefit in these patients.

journal_name

J Neurosurg Sci

journal_title

Journal of neurosurgical sciences

authors

Ravindra VM,Guan J,Holland CM,Dailey AT,Schmidt MH,Godzik J,Hood RS,Ray WZ,Bisson EF

doi

10.23736/S0390-5616.16.03846-7

subject

Has Abstract

pub_date

2019-02-01 00:00:00

pages

36-41

issue

eissn

0390-5616

issn

1827-1855

pii

R38Y9999N00A16090201

journal_volume

pub_type

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Vitamin D status in cervical spondylotic myelopathy: comparison of fusion rates and patient outcome measures.