The relationship between serum vitamin D levels and spinal fusion success: a quantitative analysis.
The relationship between serum vitamin D levels and spinal fusion success: a quantitative analysis.
复制标题
DOI：
10.1097/brs.0000000000000801
复制
发表时间：
2015-04-15
期刊：
影响因子：
3
通讯作者：
Delamarter RB
中科院分区：
文献类型：
--
作者：
Metzger MF;Kanim LE;Zhao L;Robinson ST;Delamarter RB
大鼠自体植骨后外侧脊柱融合模型中维生素D的体内给药研究。大鼠随机分为四种水平的维生素D调整大鼠饲料，纵向血清验证，外科医生/观察员对饮食条件盲目，大鼠前瞻性随访融合终点。评估饮食和血清维生素D水平对融合成功、融合块巩固和后外侧脊柱融合术后生物力学刚度的影响。代谢风险因素，包括维生素D不足，经常被脊柱外科医生忽视。目前还没有关于缺乏或缺乏维生素D水平对脊柱融合术后成功建立实骨愈合的因果关系的公开数据。50只大鼠随机分为四种实验对照大鼠饮食：正常对照、维生素D缺乏、维生素D不足和无毒高剂量维生素D，术前四周并在术后维持至牺牲。在手术和牺牲时用放射免疫法测定血清25(OH)D水平。后外侧融合手术与尾部自体移植物。术后12周处死大鼠，通过手触诊、高分辨率x线片、μCT和生物力学测试评估融合情况。血清25(OH)D和钙水平与维生素D调整后的饲料显著相关（p<0.001）。维生素D调整食物和人工触诊融合之间存在剂量依赖关系，维生素D高和维生素D缺乏之间的放射密度测量差异最大（p<0.05）。充足的维生素D水平（高和正常对照）比不足水平（不足和缺乏）产生更硬的融合（p<0.05）。人工触诊融合率随着膳食维生素D的补充而增加。生物力学刚度、骨量和密度也与维生素D和钙呈正相关。
An in vivo dosing study of vitamin D in a rat posterolateral spinal fusion model with autogenous bone grafting. Rats randomized to four levels of Vitamin D adjusted rat chow, longitudinal serum validation, surgeons/observers blinded to dietary conditions, and rats followed prospectively for fusion endpoint. To assess the impact of dietary and serum levels of Vitamin D on fusion success, consolidation of fusion mass, and biomechanical stiffness after posterolateral spinal fusion procedure. Metabolic risk factors, including vitamin D insufficiency, are often overlooked by spine surgeons. Currently there are no published data on the causal effect of insufficient or deficient vitamin D levels on the success of establishing solid bony union after a spinal fusion procedure. 50 rats were randomized to four experimentally controlled rat chow diets: normal control, vitamin D-deficient, vitamin-D insufficient, and a non-toxic high dose of vitamin D, four weeks prior to surgery and maintained post-surgery until sacrifice. Serum levels of 25(OH)D were determined at surgery and sacrifice using radioimmunoassay. Posterolateral fusion surgery with tail autograft was performed. Rats were sacrificed 12 weeks post-operatively and fusion was evaluated via manual palpation, high resolution radiographs, μCT, and biomechanical testing. Serum 25(OH)D and calcium levels were significantly correlated with vitamin-D adjusted chow (p<0.001). There was a dose dependent relationship between vitamin D adjusted chow and manual palpation fusion with greatest differences found in measures of radiographic density between high and deficient vitamin D (p<0.05). Adequate levels of vitamin D (high and normal control) yielded stiffer fusion than inadequate levels (insufficient and deficient) (p<0.05). Manual palpation fusion rates increased with supplementation of dietary vitamin D. Biomechanical stiffness, bone volume and density were also positively-related to vitamin D, and calcium.