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Vitamin D deficiency during the perioperative period increases the rate of hardware failure and the need for revision fusion in adult patients undergoing single-level lumbar spine instrumentation surgery
- Source :
- N Am Spine Soc J
- Publication Year :
- 2023
- Publisher :
- Elsevier, 2023.
-
Abstract
- BACKGROUND: Vitamin D has been shown to play important roles in both calcium homeostasis and bone healing. Only three studies have directly examined the relationship between vitamin D deficiency and hardware failure, nonunion, and/or revision surgery. Results are contradictory and none were large enough to provide the statistical power necessary to make definitive conclusions. METHODS: A retrospective analysis was performed utilizing the PearlDiver national insurance claims database consisting of 91 million individual patient records. Patients aged 30 and over who underwent a non-segmental posterior lumbar fusion procedure (CPT-22840) in 2012-2019 were included. Data collected included, hardware failure, revision surgery occurrence, and vitamin D deficiency. Hardware failure and revision rates were compared between vitamin D deficient and non-deficient groups. We ran a logistic regression analysis using the following variables: age, Charlson Comorbidity Index (CCI), gender, vitamin D deficiency, obesity, tobacco use, diabetes, osteoporosis, rheumatoid arthritis, and Crohn's disease. RESULTS: 108,137 patients matching inclusion criteria were identified, with an overall hardware failure rate of 2.7% and revision rate of 4.1%. Failure rates were significantly higher for patients diagnosed with vitamin D deficiency during the full queried period (3.3% vs. 2.6%, OR = 1.26; p < 0.0001), as were revision rates (4.3% vs 3.5%, OR = 1.25; p < 0.0001). Patients diagnosed with deficiency pre-surgery, higher failure (3.1% vs 2.6%, OR = 1.19; p < 0.01) and rates of revision (4.4% vs 3.5%, OR = 1.27; p < 0.0001) were increased compared to the non-deficient group. In the logistic regression analysis, vitamin D deficiency remains a significant contributor to hardware failure and revision surgery. CONCLUSIONS: These results demonstrate that pre- and/or post-operative vitamin D deficiency is independently correlated with risk for hardware failure and revision surgery in single-level lumbar fusion patients.
- Subjects :
- Clinical Studies
Orthopedics and Sports Medicine
Surgery
Neurology (clinical)
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- N Am Spine Soc J
- Accession number :
- edsair.doi.dedup.....ada55557adea6da9e6a31b9cb5eeccb9