Lee Myung Ho, Gong Hyun Sik, Lee Min Ho, Cho Kwan Jae, Kim Jihyeung, Baek Goo Hyun
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
J Hand Surg Am. 2019 Aug;44(8):649-654. doi: 10.1016/j.jhsa.2019.03.008. Epub 2019 Apr 29.
Studies suggest that vitamin D supplementation improves myelination and recovery after nerve injuries. The purpose of this study was to evaluate whether correction of vitamin D level leads to better surgical outcomes in women with both carpal tunnel syndrome (CTS) and vitamin D deficiency.
We retrospectively reviewed 84 vitamin D-deficient women with CTS who underwent carpal tunnel release and then received daily vitamin D supplementation of 1,000 IU vitamin D for 6 months. We also reviewed 35 control patients who were vitamin D-nondeficient at baseline and thus did not receive the supplementation. At baseline and 6 months after surgery, we measured serum vitamin D levels, the Disabilities of the Arm, Shoulder, and Hand (DASH) score, motor conduction velocity, and grip and pinch strengths. We compared the outcomes of CTS related to vitamin D levels. We also correlated baseline and follow-up vitamin D levels with the assessed parameters.
At 6 months, 59 patients became vitamin D-nondeficient (≥ 20 ng/mL) and 25 were still vitamin D-deficient (< 20 ng/mL). Patients who became vitamin D-nondeficient had subtle but better DASH scores than patients who were still vitamin D-deficient or the control patients. Vitamin D levels at 6 months were found to have significant correlation with the DASH score at 6 months. Vitamin D levels at 6 months did not have significant correlation with motor conduction velocity or grip and pinch strengths.
Women with CTS and vitamin D deficiency showed subtle but better DASH scores after surgery when vitamin D deficiency was corrected by supplementation.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
研究表明补充维生素D可改善神经损伤后的髓鞘形成及恢复情况。本研究旨在评估纠正维生素D水平是否能使患有腕管综合征(CTS)且维生素D缺乏的女性获得更好的手术效果。
我们回顾性分析了84例维生素D缺乏的CTS女性患者,她们接受了腕管松解术,随后每天补充1000 IU维生素D,持续6个月。我们还回顾了35例基线时维生素D不缺乏因而未接受补充治疗的对照患者。在基线及术后6个月,我们测量了血清维生素D水平、上肢、肩部和手部功能障碍(DASH)评分、运动传导速度以及握力和捏力。我们比较了与维生素D水平相关的CTS手术效果。我们还将基线和随访时的维生素D水平与评估参数进行了相关性分析。
6个月时,59例患者维生素D不缺乏(≥20 ng/mL),25例仍维生素D缺乏(<20 ng/mL)。维生素D不缺乏的患者DASH评分虽细微但优于仍维生素D缺乏的患者或对照患者。发现6个月时的维生素D水平与6个月时的DASH评分显著相关。6个月时的维生素D水平与运动传导速度或握力和捏力无显著相关性。
CTS且维生素D缺乏的女性患者,通过补充治疗纠正维生素D缺乏后,术后DASH评分虽细微但有所改善。
研究类型/证据水平:治疗性IV级。