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维生素 D 补充剂对手术治疗腰椎管狭窄症(LSS)患者功能结局和生活质量(QoL)的影响。

The effectiveness of vitamin D supplementation in functional outcome and quality of life (QoL) of lumbar spinal stenosis (LSS) requiring surgery.

机构信息

Department of Orthopaedic Surgery, College of Medicine, Daegu Catholic University, Duryugongwon-ro 17-gil, Nam-gu, Daegu city, Korea.

Department of Biochemistry and Cell Biology, Kyungpook National University, Daegu, Korea.

出版信息

J Orthop Surg Res. 2020 Mar 24;15(1):117. doi: 10.1186/s13018-020-01629-2.

Abstract

STUDY DESIGN

This is a retrospective cohort comparative study.

BACKGROUND

Vitamin D supplementation is considered to be associated with good functional outcome. Thus, a few studies have proposed vitamin D supplementation is benefit to the functional outcome in LSS requiring surgery. The purpose of this study is to identify the prevalence of vitamin D deficiency in patients with LSS requiring surgery, and to compare the differences between the cases whether vitamin D is supplemented and vitamin D is not supplemented in terms of a QoL during postoperative 2 year.

METHODS

All patients with LSS who underwent surgery from March 1, 2015 to August 31, 2016 were enrolled. Among them, 61 patients with vitamin D deficiency were divided into two groups (supplemented group (A) and non-supplemented group (B)). Functional outcomes using Oswestry Disability Index (ODI) and Rolland Morris Disability Index (RMDQ) and QoL using SF-36 were evaluated at 12-month and 24-month follow-up periods. Differences in functional score and SF-36 between the vitamin D supplemented and non-supplemented group were compared.

RESULTS

Among the total 102 patients, 78 patients (76.5%) had vitamin D deficiency. Of the 78 patients, 61 patients were included, 27 patients were group A and 27 patients were group B. There was no difference in age and 25-OHD level between the two groups (all 0 > 0.05). Group A were better functional outcomes at 2 years after surgery (p < 0.05). On the QoL, group A were higher score than group B from 12 month later after surgery (p < 0.05).

CONCLUSIONS

Vitamin D deficiency was highly prevalent in LSS patients (76.5%). Assessment of serum 25-hydroxyvitamin D (25(OH)D) is recommended in LSS needing surgical intervention and active treatment vitamin D supplementation and maintenance of normal range should be considered for better postoperative functional outcome and QoL.

摘要

研究设计

这是一项回顾性队列比较研究。

背景

维生素 D 补充被认为与良好的功能结果相关。因此,一些研究提出维生素 D 补充对需要手术的 LSS 的功能结果有益。本研究的目的是确定需要手术的 LSS 患者中维生素 D 缺乏的患病率,并比较手术后 2 年内维生素 D 补充组和未补充组之间 QoL 的差异。

方法

纳入 2015 年 3 月 1 日至 2016 年 8 月 31 日期间接受手术的所有 LSS 患者。其中,61 例维生素 D 缺乏患者分为两组(补充组(A)和未补充组(B))。在 12 个月和 24 个月随访时,使用 Oswestry 残疾指数(ODI)和 Rolland Morris 残疾指数(RMDQ)评估功能结果,使用 SF-36 评估 QoL。比较维生素 D 补充组和未补充组之间功能评分和 SF-36 的差异。

结果

在 102 例患者中,78 例(76.5%)存在维生素 D 缺乏。在 78 例患者中,纳入 61 例患者,其中 27 例为 A 组,27 例为 B 组。两组患者年龄和 25-羟维生素 D 水平无差异(均 P > 0.05)。术后 2 年时,A 组功能结果更好(P < 0.05)。在 QoL 方面,术后 12 个月后,A 组评分高于 B 组(P < 0.05)。

结论

LSS 患者维生素 D 缺乏发生率很高(76.5%)。建议对需要手术干预的 LSS 患者进行血清 25-羟维生素 D(25(OH)D)评估,并考虑积极治疗维生素 D 补充和维持正常范围,以获得更好的术后功能结果和 QoL。

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