Prevalence and Significance of Vitamin D Deficiency in Patients Undergoing Corrective Surgery for Adolescent Idiopathic Scoliosis.

Abstract

The exact etiology of adolescent idiopathic scoliosis (AIS) is unknown, but recently, vitamin D has been suggested to be of importance in the pathophysiology of AIS. This article sought to (1) highlight the prevalence of vitamin D deficiency in patients undergoing corrective surgery for AIS within the United Kingdom and (2) evaluate the correlation and clinical relevance of preoperative back pain with vitamin D deficiency. Data were collected on 201 consecutive patients undergoing corrective surgery for AIS. Baseline data included patient demographics, medical diagnoses, and standing preoperative Cobb angles. All patients had a preoperative 25-hydroxyvitamin D level recorded. One hundred ninety-six patients completed preoperative Scoliosis Research Society-22 outcome scores to quantify preoperative back pain. A total of 177 (89%) patients were young women, and the mean age at time of surgery was 14.9 years (13-18 years). All patients were diagnosed with AIS. The mean Cobb angles at time of surgery was 64°. Only 11 (5.5%) patients had "normal" vitamin D levels (>75 nmol/L), with 147 (74%) patients having deficient levels requiring treatment with supplementation. There was no correlation between vitamin D levels and preoperative Cobb angles (r s = -0.12), and there was a moderate correlation identified between the severity of preoperative vitamin D levels and preoperative back pain scores (r s =0.42). Vitamin D deficiency is common in patients with AIS; however, it is comparable to the national prevalence of vitamin D deficiency in healthy adolescent children. There was a strong correlation between preoperative back pain scores and the severity of vitamin D deficiency. These findings suggest that all patients with AIS should be screened for vitamin D deficiency and that supplementation where appropriate may lead to improved pain scores. If vitamin D is prevelant and if vitamin D deficiency is found to cause back pain, then there is an easy/cheap/safe treatement with supplementation.