Table of Contents
ISRN Orthopedics
Volume 2013, Article ID 471695, 12 pages
http://dx.doi.org/10.1155/2013/471695
Review Article

Vitamin D Status and Spine Surgery Outcomes

Nola Physical Therapy, 2 West 45th Street, Suite 208, New York, NY 10036, USA

Received 20 February 2013; Accepted 19 March 2013

Academic Editors: M. Kawakami, C.-H. Lee, and B. K. Weiner

Copyright © 2013 William J. Rodriguez and Jason Gromelski. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

There is a high prevalence of hypovitaminosis D in patients with back pain regardless of whether or not they require surgical intervention. Furthermore, the risk of hypovitaminosis D is not limited to individuals with traditional clinical risk factors. Vitamin D plays an essential role in bone formation, maintenance, and remodeling, as well as muscle function. Published data indicate that hypovitaminosis D could adversely affect bone formation and muscle function in multiple ways. The literature contains numerous reports of myopathy and/or musculoskeletal pain associated with hypovitaminosis D. In terms of spinal fusion outcomes, a patient may have a significant decrease in pain and the presence of de novo bone on an X-ray, yet their functional ability may remain severely limited. Hypovitaminosis D may be a contributing factor to the persistent postoperative pain experienced by these patients. Indeed, hypovitaminosis D is not asymptomatic, and symptoms can manifest themselves independent of the musculoskeletal pathological changes associated with conditions like osteomalacia. It appears that vitamin D status is routinely overlooked, and there is a need to raise awareness about its importance among all healthcare practitioners who treat spine patients.