The Relationship between the Severity of Lumbar Spinal Stenosis and Levels of Vitamin D and Parathyroid Hormone

Abstract

Background: It is known that parathyroid hormone (PTH) and vitamin D have a wide variety of effects on bone metabolism. However, the levels of PTH and vitamin D in patients with lumbar spinal stenosis (LSS) have not been adequately investigated in the literature. Objective: The objective of this study was to investigate the relationship between PTH and vitamin D levels and the severity of stenosis in patients with LSS. Materials and Methods: This retrospective observational study included consecutive patients who presented to the Neurosurgery outpatient clinic with chronic leg pain and low back pain and were diagnosed with LSS between January 2019 and July 2022. Patients were categorized into three groups based on their vitamin D and parathyroid hormone status. Group 1: High parathyroid hormone and Low vitamin D levels; Group 2: Normal parathyroid hormone and low vitamin D levels; Group 3: Normal parathyroid hormone and vitamin D levels. There were 17 (37%), 10(22%), and 19(41%) subjects in groups I, II, and III, respectively. Results: The mean age of the groups with a total of 46 patients I, II and III were 62.2±11, 58.3±6, and 63.2±6.4 years, respectively (p=0.553). Sex of the study groups was not statistically different, either (p=0.079). Spinal canal AP diameter (p=0.002) and ligamentous interfacet distance (p=0.008) were significantly different in study groups. Vitamin D positively correlated with Spinal canal AP diameter (r=0.56, p<0.001) and ligamentous interfacet distance (r=0.51, p=0.003), while PTH was inversely correlated with them (r=-0.33, p=0.020), ( r=-0.47, p=0.007) . Conclusion: Vitamin D is significantly correlated with the diameters of spinal canal AP and ligamentous interfacet distance. PTH is negatively correlated with the diameters of spinal canal AP and ligamentous interfacet distance. Keywords: Lumbar spinal stenosis, Vitamin D, Parathyroid hormone, Neurogenic claudication, Low back pain, Ligamentous interfacet distance.