Vitamin D Deficiency and Surgical Outcome in Adolescent Idiopathic Scoliosis in Low Socioeconomic Status in Rural India

Introduction: Patients with adolescent idiopathic scoliosis (AIS) have a higher prevalence of Vitamin D deficiency compared with healthy peers. Hypothesis: Vitamin D deficiency in AIS patients does not have a good functional outcome after posterior instrumented corrective spinal fusion. Materials and Methods: A prospective consecutive study of 62 children who underwent surgery for AIS had pre-operative measurement of Vitamin D levels [serum 25-hydroxyvitamin D (ng/mL)]. Post-operative AIS patients were followed up for 2 years after surgery. Data on the history of back pain, socioeconomic status, curve magnitude, age, and gender were recorded. Patients were categorized based on Vitamin D level: deficient (<20 ng/mL), insufficient (20–29 ng/mL), or sufficient (≥30 ng/mL). The correlation between Vitamin D levels and Scoliosis Research Society (SRS)-22 scores was analyzed using multivariable analysis and pair-wise comparisons using Tukey method. Results: Sixty-two AIS patients (47 Females and 15 Males) were enrolled who underwent posterior instrumented spine fusion. The mean age at surgery was 15.24 ± 4.5 years. Major coronal curves had a mean of 68.08 ± 12° preoperatively and 12.19 ± 4.2° postoperatively. It was found that 35 (56.45%) of patients were Vitamin D deficient, 23 (37.09%) were insufficient, and 4 (6.45%) were sufficient. Although there was no correlation between Vitamin D level and pain, mental health, or satisfaction domains (P > 0.05), Vitamin D-deficient patients were found to be younger than 18 years of age (P < 0.001) and had lower SRS-22 function (P = 0.010), Self-image (P = 0.049), and total scores (P = 0.007). Conclusion: AIS patients with Vitamin D deficiency (<20 ng/mL) are more likely to be younger at the time of surgery, and report lower function, self-image, and total SRS-22 scores postoperatively. Keywords: Adolescent Idiopathic Scoliosis, Posterior Spinal Fusion, Vitamin D Deficiency