Prevalence of Vitamin D Deficiency in Patients Undergoing Elective Spine Surgery: A Cross-Sectional Analysis

Ravindra, Vijay M.; Godzik, Jakub; Guan, Jian; Dailey, Andrew T.; Schmidt, Meic H.; Bisson, Erica F.; Hood, Robert S.; Ray, Wilson Z.

doi:10.1016/j.wneu.2014.12.031

Cited by 42 publications

(33 citation statements)

References 25 publications

(28 reference statements)

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“…[102027] Nakamura et al . (2014) evaluated fracture risks utilizing standardized incidence (SIRs) and hazard ratios (HR) in 258 patients undergoing initial bariatric procedures (gastric bypass 94%) [Table 4].…”

Section: Pros and Cons Of Bariatric Surgery In Morbidly Obese Patientsmentioning

confidence: 99%

“…(2015) similarly documented decreased BMD/osteoporosis/osteomalacia, and vitamin D deficiency increasing the risk of fractures for 230 patients undergoing elective instrumented spinal procedures (degenerative spinal spondylosis or spinal instability) [Table 4]. [27] All patients had serum 25-OH (Hydroxy) vitamin D levels drawn within less than <72 hours of surgery. For these patients, 89 9 (38.9%) had laboratory confirmed Vitamin D Insufficiency, there were more males age 40-60 who were osteopenic/osteoporotic vs. females.…”

Section: Pros and Cons Of Bariatric Surgery In Morbidly Obese Patientsmentioning

confidence: 99%

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More risks and complications for elective spine surgery in morbidly obese patients

Epstein¹

2017

Surg Neurol Int

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Background:The vast majority of studies emphasize the greater morbidity/mortality for elective spine surgery in morbidly obese patients.Methods:This review focuses on the increased morbidity/mortality of performing elective spinal operations in morbidly obese patients. There are two definitions of morbid obesity; a body mass index (BMI) of equal to or greater than 35 plus two major comorbid factors (e.g., hypertension, diabetes, etc.) or a BMI (morbidly obese III) of =≥40 kg/m2.Results:For patients undergoing spinal surgery, morbid obesity increases perioperative morbidity/mortality for various reasons. The quality of preoperative and intraoperative imaging is often compromised potentially leading to mistaken preoperative diagnoses, and wrong level surgery. Resultant major technical surgical limitations include poor/inadequate operative exposure, and the risk of suboptimal placement of instrumentation There is also increased exposure to major perioperative complications such as deep venous thrombosis, pulmonary embolism, infection, pneumonia, cardiac complications, blindness in the prone position, brachial and lumbar plexus injuries, increased anesthetic risks (e.g., even using awake intubation/awake positioning), and postoperative wound seromas/hematomas.Conclusions:Most of the spinal literature documents the marked increased perioperative morbidity/mortality for morbidly obese patients undergoing elective spine surgery. If elective surgery is warranted in these patients, the risks and timing of surgical intervention should include consideration of major preoperative weight loss strategies including bariatric procedures to optimize outcomes.

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Section: Pros and Cons Of Bariatric Surgery In Morbidly Obese Patientsmentioning

confidence: 99%

Section: Pros and Cons Of Bariatric Surgery In Morbidly Obese Patientsmentioning

confidence: 99%

More risks and complications for elective spine surgery in morbidly obese patients

Epstein¹

2017

Surg Neurol Int

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“…Fragility fracture and osteoporosis epidemiology References: 1,2,7-21 Treatment strategies and treatment deficiencies following fragility fracture References: [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] Bone health and elective spine surgery outcomes References: 3,5,6, Osteoporosis treatment and elective spine surgery outcomes References: 8,39,[60][61][62][63][64][65][66][67][68] Table 3. 2016 AACE Diagnosis of Osteoporosis in Postmenopausal Women.…”

Section: Vertebral Fragility Fracturementioning

confidence: 99%

“…6,37,38 Ravindra et al found that 30.0% of patients undergoing elective spine fusion surgery had vitamin D deficiency; Stoker et al similarly found that 27.0% of patients undergoing spine fusion surgery had vitamin D deficiency. 39,40 Subsequent studies have shown that vitamin D deficiency has a negative impact on spine fusion outcomes. Ravindra et al showed that vitamin D deficiency was an independent predictor of nonunion and that the time to fusion in patients with vitamin D deficiency was significantly longer.…”

Section: Bone Fragility and Its Impact On Elective Spine Surgerymentioning

confidence: 99%

“…9,60 Low vitamin D levels lead to increased bone resorption and turnover, which in turn can predispose patients to osteoporosis. 39,61,62 Ensuring adequate daily intake and/or supplementation when deficiencies are noted can mitigate these negative effects. An example of a strategy for preoperative vitamin D optimization based on expert opinion at the Mayo Clinic is shown in Table 4.…”

Section: Bone Health Assessment Prior To Elective Spine Surgerymentioning

confidence: 99%

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A Review and Clinical Perspective of the Impact of Osteoporosis on the Spine

Carlson

Robinson

Wanderman

et al. 2019

Geriatr Orthop Surg Rehabil

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Introduction: Osteopenia and osteoporosis are common conditions in the United States. The health consequences of low bone density can be dire, from poor surgical outcomes to increased mortality rates following a fracture. Significance: This article highlights the impact low bone density has on spine health in terms of vertebral fragility fractures and its adverse effects on elective spine surgery. It also reviews the clinical importance of bone health assessment and optimization. Results: Vertebral fractures are the most common fragility fractures with significant consequences related to patient morbidity and mortality. Additionally, a vertebral fracture is the best predictor of a subsequent fracture. These fractures constitute sentinel events in osteoporosis that require further evaluation and treatment of the patient’s underlying bone disease. In addition to fractures, osteopenia and osteoporosis have deleterious effects on elective spine surgery from screw pullout to fusion rates. Adequate evaluation and treatment of a patient’s underlying bone disease in these situations have been shown to improve patient outcomes. Conclusion: With an increased understanding of the prevalence of low bone mass and its consequences as well an understanding of how to identify these patients and appropriately intervene, spine surgeons can effectively decrease the rates of adverse health outcomes related to low bone mass.

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Preoperative Preparation of Osteoporotic Patients for Instrumented Spine Surgery

Hartmann

Koller

2019

Evidence for Neurosurgery

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Prevalence of Vitamin D Deficiency in Patients Undergoing Elective Spine Surgery: A Cross-Sectional Analysis

Cited by 42 publications

References 25 publications

More risks and complications for elective spine surgery in morbidly obese patients

More risks and complications for elective spine surgery in morbidly obese patients

A Review and Clinical Perspective of the Impact of Osteoporosis on the Spine

Preoperative Preparation of Osteoporotic Patients for Instrumented Spine Surgery

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