Researchers studied 47 kids and teens with curved spines who had surgery to straighten them. They found that kids who didn’t have enough vitamin D before surgery started out feeling worse than those with healthy vitamin D levels. However, after the doctors gave them extra vitamin D and performed the surgery, the kids who were low in vitamin D improved significantly and felt just as good as the other group two years later. This suggests that checking vitamin D levels before spine surgery and giving kids extra vitamin D might help them recover better and feel more comfortable after their operation.

The Quick Take

  • What they studied: Whether kids with low vitamin D levels who get extra vitamin D before and after spine surgery for curved spines recover better than kids with normal vitamin D levels
  • Who participated: 47 kids and teenagers (ages 11-20) who had spine surgery between 2018 and 2022 for idiopathic scoliosis (a curved spine with no known cause). About half had low vitamin D levels at the start
  • Key finding: Kids with low vitamin D started out with lower quality-of-life scores before surgery, but after receiving vitamin D supplements and having surgery, their scores improved and matched those of kids who had normal vitamin D levels by two years after surgery
  • What it means for you: If your child needs spine surgery, doctors should check their vitamin D levels beforehand. If levels are low, giving vitamin D supplements before and after surgery may help them recover better and feel more comfortable. This is a promising finding, but more research is needed to confirm these results

The Research Details

This was a retrospective case-control study, which means researchers looked back at medical records of kids who had already had spine surgery. They compared two groups: kids who had low vitamin D levels before surgery and kids who had normal vitamin D levels. The kids with low vitamin D were given vitamin D supplements (either 800-2000 units daily or 50,000 units weekly) before and after their surgery. Researchers then compared how well both groups recovered using a special questionnaire that measures how kids feel about their physical function, pain, self-image, and other quality-of-life factors.

The study included kids aged 11 to 20 years who had surgery between 2018 and 2022 and were followed for at least 2 years after surgery. Researchers used statistical tests to compare the two groups and see if vitamin D levels were connected to how curved the spine was before surgery.

This research approach is important because it looks at real-world outcomes in actual patients rather than just laboratory results. By following kids for two full years after surgery, researchers could see the long-term effects of vitamin D on recovery. The comparison between vitamin D-deficient and sufficient groups helps show whether vitamin D specifically makes a difference, rather than just the surgery alone

This study has some strengths: it followed patients for a full two years, used a validated questionnaire to measure outcomes, and had clear definitions of vitamin D deficiency. However, it has limitations: it’s a smaller study (47 patients), it’s retrospective (looking back at records rather than planning the study in advance), and it doesn’t prove that vitamin D caused the improvement—only that it was associated with better outcomes. The researchers didn’t randomly assign kids to receive vitamin D or not, which is the gold standard for proving cause-and-effect

What the Results Show

Before surgery, kids with low vitamin D had lower quality-of-life scores (4.4 out of a scale) compared to kids with normal vitamin D (4.6 out of the same scale). This difference was small but statistically significant, meaning it wasn’t just due to chance. However, two years after surgery, both groups had similar scores, suggesting they recovered equally well.

When researchers looked at specific areas measured by the questionnaire, kids with low vitamin D showed improvement in four areas: physical function, management of their condition, pain levels, and self-image. Kids with normal vitamin D improved in two of these areas: management and self-image. This suggests that kids starting with low vitamin D had more room to improve and did improve more in certain areas.

Researchers also found a weak connection between vitamin D levels and how curved the spine was before surgery—kids with lower vitamin D tended to have slightly more curved spines, though this relationship was not strong.

The study found that vitamin D deficiency was common in this group, affecting 53% (more than half) of the kids. The average vitamin D level in the deficient group was 21 ng/mL, while the sufficient group averaged 41 ng/mL. Kids in the deficient group received vitamin D supplements ranging from 800 to 2,000 units daily or 50,000 units weekly, which successfully brought their levels up to normal range

Previous research has suggested that vitamin D plays a role in bone health and recovery from surgery, but this is one of the first studies to specifically look at vitamin D and recovery in kids having spine surgery for scoliosis. The finding that vitamin D-deficient kids caught up to sufficient kids after treatment aligns with other research showing that correcting vitamin D deficiency can improve health outcomes

This study has several important limitations. First, it’s relatively small with only 47 patients, so results might not apply to all kids with scoliosis. Second, it’s a retrospective study looking back at records rather than a prospective study where researchers plan the study in advance and randomly assign kids to receive vitamin D or not. Third, the study doesn’t prove that vitamin D caused the improvement—only that kids who received it did better. Other factors like surgery quality, physical therapy, or family support could have contributed to the improvement. Finally, the study was done at one hospital system, so results might differ in other locations or populations

The Bottom Line

Based on this research, doctors should consider screening kids for vitamin D deficiency before spine surgery and giving vitamin D supplements if levels are low. The evidence is moderate strength because this is a smaller study that shows association rather than definitive cause-and-effect. Parents should discuss vitamin D screening with their child’s surgeon before any planned spine surgery

This research is most relevant for kids and teens (ages 11-20) who need surgery to correct curved spines due to idiopathic scoliosis. It may also be relevant for kids having other types of spine surgery, though more research is needed. This is less relevant for kids with scoliosis who are not having surgery or for adults having spine surgery, as the study only included children and teens

Based on this study, kids with low vitamin D who receive supplements before surgery may start feeling better within the first few months after surgery. The study measured outcomes at two years, so it took a full two years to see the complete picture of recovery. However, kids may notice improvements in pain and physical function sooner than that

Want to Apply This Research?

  • If your child is preparing for spine surgery, track their vitamin D levels monthly starting 3 months before surgery. Record the date, vitamin D level (in ng/mL), and supplement dose taken. This helps ensure levels are rising appropriately before surgery
  • Set daily reminders to take vitamin D supplements at the same time each day (morning with breakfast works well). Use the app to log each dose taken and set a goal to take supplements on at least 90% of days. After surgery, continue tracking supplements and note any changes in pain levels, physical activity, or how you feel overall
  • Create a long-term tracking system that measures: (1) vitamin D supplement adherence (percentage of days taken), (2) vitamin D blood levels (checked every 3 months), (3) pain levels on a 1-10 scale (weekly), (4) physical activity and function (weekly), and (5) overall quality of life (monthly). Compare these metrics before surgery, immediately after, and at 6-month intervals through 2 years post-surgery

This research suggests an association between vitamin D levels and recovery outcomes in kids having spine surgery, but it does not prove that vitamin D supplements will definitely improve your child’s recovery. This study was relatively small and looked back at past medical records rather than randomly assigning kids to receive vitamin D or not. Always consult with your child’s surgeon or doctor before starting any vitamin D supplements or making changes to their care plan. Do not use this information to replace professional medical advice. If your child is scheduled for spine surgery, discuss vitamin D screening and supplementation with their healthcare team to determine what’s appropriate for their specific situation.