Caveat For Vitamin D Levels in Spine Surgery Patients

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A recent study conducted by the orthopaedic surgeons at the Washington University School of Medicine in St. Louis found that those spinal fusion surgery patients who were deficient in Vitamin D before the surgery had a long recovery phase.

Spinal fusion surgery is a major surgery that is usually recommended to remove the spinal canal of bone and tissue material obstructing/narrowing the canal or squeezing the spinal cord. The surgery lasts several hours and is also prescribed to correct fractures of the spine and treat herniated discs, tumors etc. (1)

The findings of the Washington University School of Medicine were presented in the 26th Annual Meeting of the North American Spine Society. The study had examined 313 spinal fusion surgery patients and found that more than 50% of them had low Vitamin D levels that made the recovery phase for them a long and gradual curve. What is even more interesting is that the levels of Vitamin D were noted after the surgery was done for the patients and the recovery was taking longer than expected. Of the 313 patients, 25% were found to be severely deficient of Vitamin D post surgery. (2)

As per the study’s principal investigator Jacob M. Buchowski, MD, “Our findings suggest it may be worthwhile to screen surgery patients for vitamin D. 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.” (3)

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When ultra-violet rays shine on our skin, a cholesterol-like substance gets converted to Vitamin D and absorbed into the blood. Vitamin D is required for the metabolisation of calcium. Several studies are now pointing that mere increase of one’s calcium intake late in life does not offer the same level of protection for bone health you get when vitamin D is added as well.

Because Vitamin D helps in the metabolization and absorption of calcium, those who are deficient of Vitamin D can develop a condition called osteomalacia. Osteomalacia interferes with new bone formation or the production of osteoblasts (bone cells). The current accepted RDA for Vitamin D stands at 600 IU (international units) per day.

Of the different types of spinal fusion surgery, the type that was under study was the procedure that involved the removal of discs between two or more vertebrae. This done, the bines are then attached with hardware and treated for growth factors. When the procedure is completed, the spine begins it’s healing process as new bone begins to form and the vertebrae fuse together.

When the study observed the case of particular 40 year old woman with slow recovery and discovered an alarmingly low level of Vitamin D, the team began a routine check screening all the spinal fusion injury patients for Vitamin deficiency. The discovery came as an eye-opener because it was common to note elder patients with low levels of the vitamins and in this case younger patients were showing similar deficiency levels. (4)

Vitamin D levels took a hit from factors such as obesity, smoking and not keeping a check on Vitamin D levels, family history of fractures etc. Buchowski recommends spinal fusion surgery patients to have their Vitamin D levels checked prior to surgery and take corrective action (supplements and exposure to Sun) before proceeding with the surgery.


SOURCES:

1. Spinal Fusion (Arthrodesis); WebMD; November, 2011;
    http://www.webmd.com/back-pain/spinal-fusion-arthrodesis
2. Low Vitamin D Common In Spine Surgery Patients; Washington University in St. Louis, Newsroom; November, 2011;
    http://news.wustl.edu/news/Pages/22905.aspx
3. Low Vitamin D Common in Spine Surgery Patients; Deficiency May Hinder Recovery; Science Daily; November, 2011;
    http://www.sciencedaily.com/releases/2011/11/111103081429.htm
4. Spine Surgery Patients Need Adequate Vitamin D Levels; MedScape Today; November, 2011;
    http://www.medscape.com/viewarticle/753414

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