In conclusion , this review supports the hypothesis that hypovitaminosis D is associated with adverse outcomes after diverse surgical procedures .
The importance of vitamin D for musculoskeletal health has long been recognized , and awareness of significant extra-skeletal effects in health and disease is rapidly emerging .
Although it has been possible for many decades to quantify serum markers of vitamin D deficiency , and to correct deficiency at low cost and with high safety , the influence of vitamin D status on post-surgical outcomes has only recently been identified as a research topic of interest .
To the present , these data have not been the subject matter of formal review .
Accordingly , we conducted a systematic review to assess the association between perioperative vitamin D status and outcomes after surgery .
Changes in Vitamin D Status After Surgery in Female Patients With Lumbar Spinal Stenosis and Its Clinical Significance
Study Design . A prospect i ve cohort study . Objective . To demonstrate the changes in vitamin D status after surgery in female patients with lumbar spinal stenosis ( LSS ) , and its correlation with surgical outcomes . Summary of Background Data . In patients with LSS , general health including walking ability and nutritional status can be markedly improved by decompressive surgery . It can be hypothesized that such improvement may have a positive effect on their vitamin D status . Methods . In total , 31 female patients who underwent decompression and instrumented posterolateral fusion for LSS were enrolled .  Serum 25-hydroxyvitamin D ( 25-OHD ) level  was measured before the surgery and at 1 year postoperative visit . According to serum 25-OHD level , patients were classified into 3 groups : ( 1 ) deficient group , when 25-OHD level was less than 20 ng/mL ( < 50 nmol/L ) ; ( 2 ) insufficient group , when 25-OHD level was between 20 to 30 ng/mL ( 50 nmol/L ⩽ 25-OHD < 75 nmol/L ) ; ( 3 ) and normal group , when 25-OHD level was 30 ng/mL or more ( ≥75 nmol/L ) . The Oswestry Disability Index ( ODI ) score and health-related quality of life ( EQ-5D ) were compared according to the level of 25-OHD at 1 year postoperatively . Results . Preoperatively , there were 20 patients in the deficient group , 11 patients in the insufficient group and no patient in the normal group . There were no differences in age , body mass index , preoperative ODI scores , preoperative EQ-5D index scores , and EQ-5D visual analogue scale scores between the 2 groups . Mean preoperative 25-OHD level was 15.8 ng/mL ( range , 5.2–29.4 ng/mL ) and increased to 19.5 ng/mL ( range , 6.3–47.7 ng/mL ) 1 year after surgery ( P = 0.075 ) . Significant increase of 25-OHD was noted only in the deficient group ( P = 0.017 ) . Postoperatively , there were 18 patients in the deficient group , 8 patients in the insufficient group , and 5 patients in the normal group . In the postoperative deficient group , postoperative ODI scores and EQ-5D index scores showed significantly worse outcomes than those in the other groups . The changes in serum 25-OHD level were significantly correlated with the changes in ODI scores ( r = −0.580 ; P = 0.001 ) and with the changes in EQ-5D index scores ( r = 0.379 ; P = 0.035 ) . In all the groups , postoperative ODI scores ( r = −0.665 ; P < 0.001 ) and EQ-5D index scores ( r = 0.601 ; P < 0.001 ) were significantly correlated with postoperative 25-OHD level . Conclusion .  Vitamin D deficiency was common in patients with LSS . However , vitamin D status was improved after decompressive surgery , and postoperative 25-OHD level was significantly correlated with surgical outcomes
In conclusion , this review supports the hypothesis that hypovitaminosis D is associated with adverse outcomes after diverse surgical procedures .
The importance of vitamin D for musculoskeletal health has long been recognized , and awareness of significant extra-skeletal effects in health and disease is rapidly emerging .
Although it has been possible for many decades to quantify serum markers of vitamin D deficiency , and to correct deficiency at low cost and with high safety , the influence of vitamin D status on post-surgical outcomes has only recently been identified as a research topic of interest .
To the present , these data have not been the subject matter of formal review .
Accordingly , we conducted a systematic review to assess the association between perioperative vitamin D status and outcomes after surgery .