Vitamin D: Should we be checking levels before spine fusion?

Several epidemiological studies have reported direct relationships between low vitamin D levels and multiple disease states. Hypovitaminosis D is particularly worrisome in patients undergoing spinal surgery given the high incidence of pseudoarthrosis in this patient cohort. When considering treatment of vitamin D deficiency, it is important to take into account the recommended concentrations and the recommended dietary allowance. Considering the adverse effects of hypovitaminosis D in patients undergoing spine surgery, routine pre-operative screening should be undertaken to identify at-risk patients. In addition, it is important for patients undergoing spinal fusion procedures to maintain a sufficient serum vitamin D concentration (>30 ng/mL).