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

Despite benefits, half of parents against later school start times

August 18, 2017
Leading pediatrics and sleep associations agree: Teens shouldn't start school so early.

Doctors exploring how to prescribe income security

August 18, 2017
Physicians at St. Michael's Hospital are studying how full-time income support workers hired by health-care clinics can help vulnerable patients or those living in poverty improve their finances and their health.

Schoolchildren who use e-cigarettes are more likely to try tobacco

August 17, 2017
Vaping - or the use of e-cigarettes - is widely accepted as a safer option for people who are already smoking.

Federal snack program does not yield expected impacts, researchers find

August 17, 2017
A well-intentioned government regulation designed to offer healthier options in school vending machines has failed to instill better snacking habits in a sample of schools in Appalachian Virginia, according to a study by ...

In a nutshell: Walnuts activate brain region involved in appetite control

August 17, 2017
Packed with nutrients linked to better health, walnuts are also thought to discourage overeating by promoting feelings of fullness. Now, in a new brain imaging study, researchers at Beth Israel Deaconess Medical Center (BIDMC) ...

Study shows cigarette makers shifted stance on nicotine patches, gum

August 17, 2017
The use of nicotine patches, gum, lozenges, inhalers or nasal sprays—together called "nicotine replacement therapy," or NRT—came into play in 1984 as prescription medicine, which when combined with counseling, helped ...

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.