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Research ArticleLumbar Spine

The Effect of Vitamin D Deficiency on Outcomes of Patients Undergoing Elective Spinal Fusion Surgery: A Systematic Review and Meta-Analysis

Razieh Khalooeifard, Jamal Rahmani, Roozbeh Tavanaei, Oladimeji Adebayo, Mohsen Keykhaee, Amirahmad Ahani, Alireza Zali, Zahra Vahdat Shariatpanahi and Saeed Oraee-Yazdani
International Journal of Spine Surgery February 2022, 16 (1) 53-60; DOI: https://doi.org/10.14444/8177
Razieh Khalooeifard
1 Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
PhD
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Jamal Rahmani
2 Department of Community Nutrition, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
PhD
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Roozbeh Tavanaei
3 Shohada Tajrish Neurosurgical Center of Excellence, Functional Neurosurgery Research Center, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
MD
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Oladimeji Adebayo
4 Department of Medicine, University College Hospital, Ibadan, Nigeria
PhD
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Mohsen Keykhaee
3 Shohada Tajrish Neurosurgical Center of Excellence, Functional Neurosurgery Research Center, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
MD
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Amirahmad Ahani
3 Shohada Tajrish Neurosurgical Center of Excellence, Functional Neurosurgery Research Center, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
MD
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Alireza Zali
3 Shohada Tajrish Neurosurgical Center of Excellence, Functional Neurosurgery Research Center, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
MD
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Zahra Vahdat Shariatpanahi
5 Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
MD, PhD
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Saeed Oraee-Yazdani
3 Shohada Tajrish Neurosurgical Center of Excellence, Functional Neurosurgery Research Center, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
MD
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    Figure 1

    Flow chart of included studies.

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    Figure 2

    Meta-analysis of the vitamin D deficiency effect on (A) visual analog scale and (B) Oswestry Disability Index. Weights are from random effects analysis. WMD, weighted mean difference.

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    Figure 3

    Funnel plot to assess publication bias on (A) visual analog scale and (B) Oswestry Disability Index. se(WMD), standard error (weighted mean difference); WMD, weighted mean difference.

Tables

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    Table 1

    Characteristics of included studies.

    StudyLocationStudy DesignLevel of EvidenceParticipants(n)Gender(F/M)Procedure TypeDuration of Study (mo)Outcome
    Kim et al, 201210 KoreaProspective cohort23131/0Lumbar fusion (lumbar spinal stenosis)12VAS, ODI
    Stoker et al, 20135 USCross-sectional4313176/137Lumbar, thoracic, and cervical fusion (spondylosis and deformity)15ODI
    Ravindra et al, 20152 USCross-sectional4230129/101Lumbar, thoracic, and cervical fusion (pathology unknown)12ODI
    Martins et al, 201711 BrazilProspective observational24629/17Cervical and lumbar fusion (degenerative pathology, deformity, tumor, infection, and trauma)12VAS
    Ravindra et al, 201912 USProspective observational25824/34Cervical fusion (cervical spondylotic myelopathy)12VAS, ODI
    Donnally et al, 201913 USRetrospective315073/77Lumbar and thoracic fusion (degenerative pathology, deformity, spondylosis, and lumbar spinal stenosis)20VAS
    Xu et al, 202014 ChinaRetrospective3360212/148Lumbar fusion (degenerative pathology, lumbar spinal stenosis, and spondylolisthesis)24VAS, ODI
    • ODI, Oswestry Disability Index; VAS, visual analog scale.

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    Table 2

    Quality of cohort studies assessed based on modified Newcastle-Ottawa scaling.

    A. SelectionB. Comparability of CohortsC. Outcome
    StudyRepresentiveness/Effectiveness of Exposed CohortSelection of NonexposedAscertainment of ExposureOutcome Not Present at StartAdjustment for Confounding/Bias?Adjustment ≥3 = YesAdjustment ≤3 = NoAssessment of OutcomeLength of Follow-Up Appropriate?Adequate of Follow-Up of Cohort?
    Kim et al, 201210 YESYESYESYESYESYESYESYES
    Stoker et al, 20135 YESYESYESYESYESYESYESYES
    Ravindra et al, 20152 YESYESYESYESYESYESYESYES
    Martins et al, 201711 YESYESYESYESNOYESYESYES
    Ravindra et al, 201912 YESYESYESYESYESYESYESYES
    Donnally et al, 201913 YESYESYESYESYESYESYESYES
    Xu et al, 202014 YESYESYESYESNOYESYESYES
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International Journal of Spine Surgery
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1 Feb 2022
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The Effect of Vitamin D Deficiency on Outcomes of Patients Undergoing Elective Spinal Fusion Surgery: A Systematic Review and Meta-Analysis
Razieh Khalooeifard, Jamal Rahmani, Roozbeh Tavanaei, Oladimeji Adebayo, Mohsen Keykhaee, Amirahmad Ahani, Alireza Zali, Zahra Vahdat Shariatpanahi, Saeed Oraee-Yazdani
International Journal of Spine Surgery Feb 2022, 16 (1) 53-60; DOI: 10.14444/8177

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The Effect of Vitamin D Deficiency on Outcomes of Patients Undergoing Elective Spinal Fusion Surgery: A Systematic Review and Meta-Analysis
Razieh Khalooeifard, Jamal Rahmani, Roozbeh Tavanaei, Oladimeji Adebayo, Mohsen Keykhaee, Amirahmad Ahani, Alireza Zali, Zahra Vahdat Shariatpanahi, Saeed Oraee-Yazdani
International Journal of Spine Surgery Feb 2022, 16 (1) 53-60; DOI: 10.14444/8177
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Keywords

  • vitamin D deficiency
  • oswestry disability index
  • visual analog scale
  • systematic review
  • meta-analysis
  • spinal fusion
  • bone metabolism

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