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Concurrent Treatment with Vitamin K2 and D3 on Spine Fusion in Patients with Osteoporosis-Associated Lumbar Degenerative Disorders.

  • 2021-12-15
  • Spine 47(4)
    • Wencan Zhang
    • Le Li
    • Xin Zhou
    • Kunpeng Li
    • Chen Liu
    • Xiangyu Lin
    • Njabulo Lubisi
    • Junfei Chen
    • Haipeng Si

Study Design

Type
Clinical Trial
Population
Patients with osteopenia or osteoporosis who underwent TLIF or PLIF in our department
Methods
A prospective and nonrandomized concurrent controlled trial; VK2+VD3 group received vitamin K2, vitamin D3, and calcium; control group received calcium and vitamin D3; spine fusion evaluated by CT; JOA-BPEQ and VAS assessed symptoms; BMD and bone metabolism markers measured
Duration
six months postoperatively

Study design

A prospective and nonrandomized concurrent controlled trial.

Objective

To address the early effects of concurrent treatment with vitamin K2 and vitamin D3 on fusion rates in patients who have undergone spinal surgery.

Summary of background data

Intervertebral pseudarthrosis has been reported after transforaminal lumbar interbody fusion (TLIF) or posterior lumbar interbody fusion (PLIF), especially in patients with osteopenia or osteoporosis. No study has assessed the early effects of concurrent treatment with vitamin K2 and vitamin D3 on fusion rates.

Methods

Patients with osteopenia or osteoporosis who underwent TLIF or PLIF in our department were included. Patients in the VK2+VD3 group received vitamin K2, vitamin D3, and calcium treatment, whereas subjects in the control group only received calcium and vitamin D3. Spine fusion was evaluated by computed tomography. The Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOA-BPEQ) and visual analog scale (VAS) were used to assess the clinical and neurological symptoms. Bone mineral density (BMD) and bone metabolism markers were measured for osteoporotic evaluation.

Results

Seventy-eight patients were included, and nine patients subsequently discontinued because of 2019-nCoV. At six months postoperatively, complete fusion rates were significantly higher in the VK2+VD3 group than that in the control group (91.18% vs 71.43%, P = 0.036). At six months postoperatively, BMD was increased in the VK2+VD3 group and was higher than that in the control group, although there was no significant difference. At three months postoperatively, a significant increase in procollagen type I amino terminal propeptide (91.81%) and a slight decrease in C-terminal end peptide (8.06%) were observed in the VK2+VD3 group. In both groups, the JOA-BPEQ and VAS scores were significantly improved after spine surgery.

Conclusion

Administration of vitamin K2 and vitamin D3 can increase lumbar interbody fusion rates, improve clinical symptoms, promote bone information, and avoid further decline in BMD within six months after TLIF or PLIF.Level of Evidence: 3.

Research Insights

  • Vitamin D3→Increased Spinal Fusion Rate

    At six months postoperatively, complete fusion rates were significantly higher in the VK2+VD3 group than that in the control group (91.18% vs 71.43%, P = 0.036).

    Effect
    Beneficial
    Effect size
    Moderate
  • Vitamin K2→Increased Spinal Fusion Rate

    At six months postoperatively, complete fusion rates were significantly higher in the VK2+VD3 group than that in the control group (91.18% vs 71.43%, P = 0.036).

    Effect
    Beneficial
    Effect size
    Moderate
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