The Prevalence of Vitamin D deficiency in Elective Spine Surgery: A Study in Three Orthopaedic Centers

Abstract

IntroductionDecreased bone mineral density due to osteoporosis and osteomalacia pose a significant risk for instrumentation failure and adjacent fractures in elective spinal surgery. The purpose of this study was to evaluate serum levels of 25hydroxyvitamin D (25OH D) in patients presenting for elective spine surgery and to determine whether patients with degenerative spinal disease and spinal instability need a perioperative treatment with Vitamin D substitution. Material and MethodsSerum 25-OH vitamin D levels were evaluated postoperatively (<72 hours) in patients undergoing elective spinal fusion in three orthopaedic centers, in Germany and in Greece. Patients with diagnosis of spinal instability as well as with degenerative spine disease were treated with spinal fusion. Results369 consecutive patients (mean, 68.3 ± 15.4 years) were admitted for elective spine surgery. Mean 25-OH vitamin D level was 19,44 ± 11,52 ng/mL (range, 4–71,8 ng/ mL). 228 (62.0%) patients were diagnosed with vitamin D deficiency and 87 (38.9%) were diagnosed with vitamin D insufficiency (20–30 ng/mL). There was no statistically significant difference between men and women. There was also no significant difference between the patients of the three centers. ConclusionVitamin D deficiency is very common in patients with spinal instability as well as with degenerative spine disease. Therefore an algorithm of treatment as well as a preoperative control of the Vitamin D values is required before spine fusion surgery is performed, to enhance bone mineral density and thus better pedicle screw fixation.