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Changes in vitamin D status after surgery in female patients with lumbar spinal stenosis and its clinical significance

 Kim, Tae-Hwan  ;  Yoon, Ji Young  ;  Lee, Byung Ho  ;  Jung, Hyun-Soo  ;  Park, Moon Soo  ;  Park, Jin-Oh  ;  Moon, Eun-Su  ;  Kim, Hak-Sun  ;  Lee, Hwan-Mo  ;  Moon, Seong-Hwan 
 SPINE, Vol.37(21) : 1326-1330, 2012 
Journal Title
Issue Date
Aged ; Decompression, Surgical ; Disability Evaluation ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae/surgery* ; Middle Aged ; Outcome Assessment (Health Care)/statistics & numerical data ; Postoperative Period ; Preoperative Period ; Prospective Studies ; Quality of Life ; Spinal Fusion ; Spinal Stenosis/blood* ; Spinal Stenosis/surgery* ; Vitamin D/analogs & derivatives* ; Vitamin D/blood
change ; vitamin D ; lumbar spinal stenosis ; surgery
STUDY DESIGN: A prospective cohort study. OBJECTIVE: To demonstrate the changes in vitamin D status after surgery in female patients with lumbar spinal stenosis (LSS), and its correlation with surgical outcomes. SUMMARY OF BACKGROUND DATA: In patients with LSS, general health including walking ability and nutritional status can be markedly improved by decompressive surgery. It can be hypothesized that such improvement may have a positive effect on their vitamin D status. METHODS: In total, 31 female patients who underwent decompression and instrumented posterolateral fusion for LSS were enrolled. Serum 25-hydroxyvitamin D (25-OHD) level was measured before the surgery and at 1 year postoperative visit. According to serum 25-OHD level, patients were classified into 3 groups: (1) deficient group, when 25-OHD level was less than 20 ng/mL (< 50 nmol/L); (2) insufficient group, when 25-OHD level was between 20 to 30 ng/mL (50 nmol/L ≤ 25-OHD < 75 nmol/L); (3) and normal group, when 25-OHD level was 30 ng/mL or more (≥ 75 nmol/L). The Oswestry Disability Index (ODI) score and health-related quality of life (EQ-5D) were compared according to the level of 25-OHD at 1 year postoperatively. RESULTS: Preoperatively, there were 20 patients in the deficient group, 11 patients in the insufficient group and no patient in the normal group. There were no differences in age, body mass index, preoperative ODI scores, preoperative EQ-5D index scores, and EQ-5D visual analogue scale scores between the 2 groups. Mean preoperative 25-OHD level was 15.8 ng/mL (range, 5.2-29.4 ng/mL) and increased to 19.5 ng/mL (range, 6.3-47.7 ng/mL) 1 year after surgery (P = 0.075). Significant increase of 25-OHD was noted only in the deficient group (P = 0.017). Postoperatively, there were 18 patients in the deficient group, 8 patients in the insufficient group, and 5 patients in the normal group. In the postoperative deficient group, postoperative ODI scores and EQ-5D index scores showed significantly worse outcomes than those in the other groups. The changes in serum 25-OHD level were significantly correlated with the changes in ODI scores (r = -0.580; P = 0.001) and with the changes in EQ-5D index scores (r = 0.379; P = 0.035). In all the groups, postoperative ODI scores (r = -0.665; P < 0.001) and EQ-5D index scores (r = 0.601; P < 0.001) were significantly correlated with postoperative 25-OHD level. CONCLUSION: Vitamin D deficiency was common in patients with LSS. However, vitamin D status was improved after decompressive surgery, and postoperative 25-OHD level was significantly correlated with surgical outcomes.
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hwan(김태환)
Kim, Hak Sun(김학선) ORCID logo https://orcid.org/0000-0002-8330-4688
Moon, Seong Hwan(문성환)
Moon, Eun Su(문은수)
Park, Jin Oh(박진오)
Lee, Byung Ho(이병호) ORCID logo https://orcid.org/0000-0001-7235-4981
Lee, Hwan Mo(이환모) ORCID logo https://orcid.org/0000-0002-5405-3832
Chong, Hyon Su(정현수)
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