Effect of vitamin D deficiency on surgical outcomes of degenerative cervical myelopathy

Hiroyuki Inose, MD, PhD; Takuya Takahashi, MD; Yu Matsukura, MD, PhD; Jun Hashimoto, MD, PhD; Kurando Utagawa, MD, PhD; Satoru Egawa, MD, PhD; Kentaro Yamada, MD, PhD; Takashi Hirai, MD, PhD; Kunihiko Takahashi, PhD; Toshitaka Yoshii, MD, PhD

North American Spine Society Journal (Sep 2023)

Effect of vitamin D deficiency on surgical outcomes of degenerative cervical myelopathy

Hiroyuki Inose, MD, PhD,
Takuya Takahashi, MD,
Yu Matsukura, MD, PhD,
Jun Hashimoto, MD, PhD,
Kurando Utagawa, MD, PhD,
Satoru Egawa, MD, PhD,
Kentaro Yamada, MD, PhD,
Takashi Hirai, MD, PhD,
Kunihiko Takahashi, PhD,
Toshitaka Yoshii, MD, PhD

Affiliations

Hiroyuki Inose, MD, PhD: Department of Orthopedic and Trauma Research, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8519, Japan; Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya-shi, Saitama 343-8555, Japan; Corresponding author. Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya-shi, Saitama 343-8555, Japan. Tel.: +81-48-965-1111.
Takuya Takahashi, MD: Department of Orthopedics, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
Yu Matsukura, MD, PhD: Department of Orthopedics, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
Jun Hashimoto, MD, PhD: Department of Orthopedics, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
Kurando Utagawa, MD, PhD: Department of Orthopedics, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
Satoru Egawa, MD, PhD: Department of Orthopedics, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
Kentaro Yamada, MD, PhD: Department of Orthopedic and Trauma Research, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8519, Japan
Takashi Hirai, MD, PhD: Department of Orthopedics, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
Kunihiko Takahashi, PhD: Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
Toshitaka Yoshii, MD, PhD: Department of Orthopedics, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

Journal volume & issue: Vol. 15
p. 100239

Abstract

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ABSTRACT: Background: Due to its association with bone metabolic status and muscle strength/mass, vitamin D deficiency has the potential to affect neurological symptom recovery after surgery for degenerative cervical myelopathy (DCM). However, few studies have investigated the effects of vitamin D deficiency (serum 25(OH)D <20 ng/mL) on surgical outcomes in DCM patients. Herein, we investigated the prevalence of vitamin D deficiency in patients with DCM, and determined whether vitamin D deficiency affects surgical outcomes for DCM. Methods: In this retrospective observational study we assessed the recovery rate 1 year after surgery in 91 patients diagnosed with DCM who underwent surgery. First, we analyzed the correlation between vitamin D levels and various background factors. Then, patients were divided into 2 groups according to vitamin D sufficiency, and univariate analysis was performed on vitamin D and surgical outcomes. Finally, Spearman correlation analyses were performed to identify factors correlated with recovery rate after surgery for DCM. Results: The average Japanese Orthopedic Association score for the assessment of cervical myelopathy (C-JOA score) improved postoperatively. Age was positively correlated with vitamin D levels, and parathyroid hormone levels were negatively correlated with vitamin D levels. Among the 91 patients, 79.1% of patients were diagnosed with vitamin D deficiency. No significant differences in recovery rate were found between the vitamin D-deficient and vitamin D-sufficient groups. Finally, the Spearman correlation analysis showed a positive correlation between the preoperative C-JOA motor dysfunction score in the lower extremities and the recovery rate, while age demonstrated a negative correlation with recovery rate. Conclusions: No association was found between vitamin D deficiency and clinical outcomes after surgery for DCM. The results of this study do not support the need to normalize vitamin D levels for achieving neurological improvements in patients with DCM.

Published in North American Spine Society Journal

ISSN: 2666-5484 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery; Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system
Website: https://www.journals.elsevier.com/north-american-spine-society-journal-nassj/

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