Prevalence of Vitamin D Deficiency in Pediatric Patients With Scoliosis Preparing for Spinal Surgery.

BACKGROUND

Establishing prevalence of vitamin D deficiency in elective scoliosis surgery may impact clinical outcomes. The objectives of this study were to document vitamin D status of patients with scoliosis preparing for surgical intervention in order to establish frequency of deficiency and determine characteristics influencing levels.

METHODS

Records were queried for patients with scoliosis diagnosis who underwent posterior spinal fusion or initial growing rod placement and had serum vitamin 25 hydroxyvitamin D (D25) recorded in the preoperative period. Demographic data (gender, age, body mass index [BMI], race, scoliosis type, spine surgery procedure, and season of the year) were extracted. Chi-square analysis and multivariate modeling were used to evaluate deficiency status among various demographic categories and determine the demographic factors impacting D25.

RESULTS

A total of 217 patients with a mean age of 13.6 ± 3.6 years had vitamin D levels drawn a mean of 38.7 ± 20.6 days prior to surgery. The majority of the sample presented with a diagnosis of idiopathic scoliosis (n = 126), and most patients were scheduled for spinal fusion surgery (n = 192). Nearly 75% of the study population (n = 162) demonstrated D25 values below normal. African Americans presented with greater risk of deficiency (p < .0002) compared to Caucasians, as did patients preparing for spinal fusion versus growing rod placement (p < .03). Severe hypovitaminosis D was more common in winter than any other season (p < .005). Patients with neuromuscular scoliosis demonstrated significantly higher D25 levels over the idiopathic diagnosis type (p < .0002). Gender, BMI, and age did not impact D25.

CONCLUSION

Low D25 levels are reported in pediatric patients with scoliosis preparing for corrective spinal surgery. Population subsets most at risk for deficiency in this limited study include African American children, those presenting for spinal fusion surgery, and patients admitted in winter season.