The role of concomitant vitamin D3 and K2 treatment after laminectomy in spinal stenosis surgery of patients with osteoporosis

Authors

  • Abdulsamet Emet Department of Orthopedics and Traumatology, Yuksek Ihtisas University, Private Liv Hospital, Ankara, Turkey
  • Yunus Demirtas Department of Orthopedics and Traumatology, Yuksek Ihtisas University, Private Liv Hospital, Ankara, Turkey https://orcid.org/0000-0002-4866-4127

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20232603

Keywords:

Vitamin D3, Laminectomy, Stenosis, Osteoporosis, Vitamin K2

Abstract

Background: Readmission because of ongoing pain and complaints who undergone spinal surgery with osteoporosis is increasing. This study investigated the efficacy of concomitant vitamin D3 and K2 usage in the surgical treatment of patients with lumbar spinal stenosis who have osteoporosis. The aim of the study was to treatment strategy is to reduce the patient’s low back pain and decrease readmission rates due to ongoing pain.

Methods: A total of 22 patients with osteoporosis included in the study who had lumbar decompression via laminectomy surgery with posterior instrumentation for spinal stenosis. Patients were divided into groups according to use additional supplement of vitamin D3+K2. Group 1 was control group who received only vitamin D3 and group 2 was patients who received vitamin D3+K2 treatment. Patients were called to their sixth month check-up and their pre-and post-treatment VAS scores and Roland-Morris scores were filled in and readmission rates due to ongoing pain were compared.

Results: 9 male and 13 female participants with a mean age of 64.4 were in the study. The mean T-score in bone mineral density (BMD) was -2.7 in group 1 and -2.6 in group 2. A significant difference was found when the pre-operative and post-operative VAS and RM scores of all patients were compared (p<0.05). The mean readmission rates due to ongoing pain is 4 in group 1 and 7 in group 2. A significant difference was found when readmission rates due to ongoing pain were compared (p<0.05).

Conclusions: Concomitant vitamin D3 and K2 usage in the surgical treatment of patients with lumbar spinal stenosis who have osteoporosis is a valuable treatment option to reduce the rate of admission to the hospital because of ongoing pain.

References

Athiviraham A, Yen D. Is spinal stenosis better treated surgically or nonsurgically? Clin Orthop Relat Res. 2007;458:90-3.

Katz JN, Harris MB. Clinical practice. Lumbar spinal stenosis. N Engl J Med. 2008;358(8):818-25.

Demir T, Camuşcu N, Türeyen K. Design and biomechanical testing of pedicle screw for osteoporotic incidents. Proc Inst Mech Eng H. 2012;226(3):256-62.

Bermejo F, Piñera AR, Alvarez-Galovich L. Osteoporosis and the Management of Spinal Degenerative Disease (I). Arch Bone Jt Surg. 2017;5(5):272-82.

Heini PF. The current treatment--a survey of osteoporotic fracture treatment. Osteoporotic spine fractures: the spine surgeon's perspective. Osteoporos Int. 2005;16(2):S85-92.

Ponnusamy KE, Iyer S, Gupta G, Khanna AJ. Instrumentation of the osteoporotic spine: biomechanical and clinical considerations. Spine J. 2011;11(1):54-63.

Carlson BC, Robinson WA, Wanderman NR, Sebastian AS, Nassr A, Freedman BA, et al. A Review and Clinical Perspective of the Impact of Osteoporosis on the Spine. Geriatr Orthop Surg Rehabil. 2019;10:2151459319861591.

Canalis E. New treatment modalities in osteoporosis. Endocr Pract. 2010;16(5):855-63.

Shearer MJ. Vitamin K. Lancet. 1995;345(8944):229-34.

Akbari S, Rasouli-Ghahroudi AA. Vitamin K and Bone Metabolism: A Review of the Latest Evidence in Preclinical Studies. Biomed Res Int. 2018;2018:4629383.

Iwamoto J. Vitamin K₂ therapy for postmenopausal osteoporosis. Nutrients. 2014;6(5):1971-80.

Brincat M, Gambin J, Brincat M, Calleja-Agius J. The role of vitamin D in osteoporosis. Maturitas. 2015;80(3):329-32.

Koshihara Y, Hoshi K, Ishibashi H, Shiraki M. Vitamin K2 promotes 1alpha,25(OH)2 vitamin D3-induced mineralization in human periosteal osteoblasts. Calcif Tissue Int. 1996;59(6):466-73.

Gigante A, Brugè F, Cecconi S, Manzotti S, Littarru GP, Tiano L. Vitamin MK-7 enhances vitamin D3-induced osteogenesis in hMSCs: modulation of key effectors in mineralization and vascularization. J Tissue Eng Regen Med. 2015;9(6):691-701.

Johnell O, Kanis J. Epidemiology of osteoporotic fractures. Osteoporos Int. 2005;16(2):S3-7.

Kanellakis S, Moschonis G, Tenta R, Schaafsma A, Heuvel EG, Papaioannou N, et al. Changes in parameters of bone metabolism in postmenopausal women following a 12-month intervention period using dairy products enriched with calcium, vitamin D, and phylloquinone (vitamin K(1)) or menaquinone-7 (vitamin K (2)): the Postmenopausal Health Study II. Calcif Tissue Int. 2012;90(4):251-62.

Wen L, Chen J, Duan L, Li S. Vitamin K‑dependent proteins involved in bone and cardiovascular health (Review). Mol Med Rep. 2018;18(1):3-15.

Myneni VD, Mezey E. Regulation of bone remodeling by vitamin K2. Oral Dis. 2017;23(8):1021-8.

Wu WJ, Kim MS, Ahn BY. The inhibitory effect of vitamin K on RANKL-induced osteoclast differentiation and bone resorption. Food Funct. 2015;6(10):3351-8.

Poon CC, Li RW, Seto SW, Kong SK, Ho HP, Hoi MP, et al. In vitro vitamin K(2) and 1α,25-dihydroxyvitamin D(3) combination enhances osteoblasts anabolism of diabetic mice. Eur J Pharmacol. 2015;767:30-40.

Tarantino U, Baldi J, Celi M, Rao C, Liuni FM, Iundusi R, et al. Osteoporosis and sarcopenia: the connections. Aging Clin Exp Res. 2013;25(1):S93-5.

Edwards MH, Dennison EM, Aihie Sayer A, Fielding R, Cooper C. Osteoporosis and sarcopenia in older age. Bone. 2015;80:126-30.

Rønning SB, Pedersen ME, Berg RS, Kirkhus B, Rødbotten R. Vitamin K2 improves proliferation and migration of bovine skeletal muscle cells in vitro. PLoS One. 2018;13(4):e0195432.

Lin T, Dai M, Xu P, Sun L, Shu X, Xia X, et al. Prevalence of Sarcopenia in Pain Patients and Correlation Between the Two Conditions: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc. 2022;23(5):902.e1-902.e20.

Matsuo S, Kawakami M, Minetama M, Nakagawa M, Teraguchi M, Kagotani R, et al. Clinical Features of Sarcopenia in Patients With Lumbar Spinal Stenosis. Spine (Phila Pa 1976). 2020;45(17):E1105-10.

Downloads

Published

2023-08-28

Issue

Section

Original Research Articles