Low vitamin D common in spine surgery patients

November 3, 2011
This is an X-ray of a compression fracture following spinal fusion surgery. Credit: Jacob M. Buchowski, MD

A new study indicates that many patients undergoing spine surgery have low levels of vitamin D, which may delay their recovery.

In a study of 313 patients undergoing spinal fusion surgery, orthopaedic surgeons at Washington University School of Medicine in St. Louis found that more than half had inadequate levels of vitamin D, including one-fourth who were more severely deficient.

The researchers report their findings today at the 26th Annual Meeting of the North American Spine Society. The study was chosen as one of the meeting's best papers.

The video will load shortly
Low levels of the vitamin can contribute to problems in the bones of patients undergoing spine surgery, and a new study from Washington University spine surgeons at Barnes-Jewish Hospital in St. Louis has found that inadequate vitamin D levels are alarmingly common in spine surgery patients. Credit: Washington University/BioMed Radio

"Our findings suggest it may be worthwhile to screen for vitamin D," says Jacob M. Buchowski, MD, the study's principal investigator. "We think those with insufficient levels of vitamin D may benefit from taking 50,000 international units of the vitamin once a week for eight weeks before surgery as this may help the recovery after spinal fusion surgery."

Vitamin D helps with , and patients with a deficiency can have difficulty producing new bone. They are at risk for a condition called osteomalacia. Unlike osteoporosis or osteopenia, which result from low , osteomalacia interferes with new .

All the patients in the study had spinal fusion surgery. In that procedure, surgeons remove discs between two or more vertebrae. The bones in the spine are then attached with hardware and treated with . As the spine heals, new bone begins to form, and the vertebrae fuse together.

Buchowski became aware of the vitamin D problem when a patient in her 40s experienced a slow recovery after spinal fusion surgery.

"I was examining her and trying to figure out why the didn't fuse," he says. "She mentioned that she had recently been diagnosed with , and it was like a 'light bulb' went off."

As a result, Buchowski, an associate professor of orthpaedic surgery and of , and his Washington University colleagues at Barnes-Jewish Hospital, started routinely screening patients for vitamin D deficiency.

Low vitamin D levels are known to be common in elderly patients. Surprisingly in this study, the patients most likely to have inadequate levels of the bone-building vitamin were younger.

"We rarely think about deficiency in younger patients," Buchowski says. "More of the older patients in this study had a history of taking supplements, and as a result, they had less risk for vitamin D deficiency than younger patients."

Although an earlier study had shown inadequate vitamin D levels in 43 percent of patients undergoing orthopedic procedures, this is the first look solely at patients.

Those in the study averaged 55 years of age, 56 percent were female, 41 percent were obese, and 95 percent were white. One quarter of the participants had taken vitamin D supplements in the past.

The researchers found that the main risk factors for inadequate vitamin D were smoking, obesity, disability prior to surgery and never having taken vitamin D or multivitamin supplements.

As a follow-up, Buchowski and his colleagues are planning a study to see whether there is a link between low vitamin D and poor outcomes following spinal fusion. In the meantime, he's recommending that patients having orthopedic surgery ensure they're getting enough vitamin D.

Sun exposure is one of the best ways to get the body to produce vitamin D. He also recommends that if they are not getting enough vitamin D, patients consume dairy products fortified with the vitamin and begin taking a vitamin D supplement prior to and following surgery.

"Vitamin D is inexpensive and easily stored in the body," Buchowski says. "My hunch is that having adequate levels may help the spine fuse following surgery."

To maintain bone health and normal calcium metabolism, the Institute of Medicine established a recommended daily allowance (RDA) for vitamin D of 600 international units. Buchowski says should work with their doctors to determine what supplemental level is appropriate for them.

Stoker GE, Buchowski JM, Bridwell KH, Lenke LG, Riew KD, Zebala LP, Vitamin D status of adults undergoing surgical spinal fusion. Presented Nov. 3 at the 26th Annual Meeting of the North American Spine Society in Chicago, Ill.

Explore further: Vitamin D deficiency in pneumonia patients associated with increased mortality

Related Stories

Vitamin D deficiency in pneumonia patients associated with increased mortality

May 10, 2011
A new study published in the journal Respirology reveals that adult patients admitted to the hospital with pneumonia are more likely to die if they have Vitamin D deficiency.

Experts recommend screening for vitamin D deficiency in at-risk populations

June 6, 2011
Today, The Endocrine Society released "Evaluation, Treatment, and Prevention of Vitamin D Deficiency: An Endocrine Society Clinical Practice Guideline." The clinical practice guideline (CPG) is published in the July 2011 ...

Recommended for you

Dog walking could be key to ensuring activity in later life

July 24, 2017
A new study has shown that regularly walking a dog boosts levels of physical activity in older people, especially during the winter.

Study finds 275,000 calls to poison control centers for dietary supplement exposures from 2000 through 2012

July 24, 2017
U.S. Poison Control Centers receive a call every 24 minutes, on average, regarding dietary supplement exposures, according to a new study from the Center for Injury Research and Policy and the Central Ohio Poison Center, ...

Alcohol to claim 63,000 lives over next five years, experts warn

July 24, 2017
Alcohol consumption will cause 63,000 deaths in England over the next five years – the equivalent of 35 deaths a day – according to a new report from the University of Sheffield Alcohol Research Group.

App lets patients work alone or with others to prevent, monitor, and reverse chronic disease

July 24, 2017
Lack of patient adherence to treatment plans is a lingering, costly problem in the United States. But MIT Media Lab spinout Twine Health is proving that regular interventions from a patient's community of supporters can greatly ...

Alcohol boosts recall of earlier learning

July 24, 2017
Drinking alcohol improves memory for information learned before the drinking episode began, new research suggests.

To combat teen smoking, health experts recommend R ratings for movies that depict tobacco use

July 21, 2017
Public health experts have an unusual suggestion for reducing teen smoking: Give just about any movie that depicts tobacco use an automatic R rating.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.