Preoperative Vitamin D Status of Adults Undergoing Surgical Spinal Fusion
Bibliographic record
Abstract
STUDY DESIGN: Retrospective investigation of cross-sectional data. OBJECTIVE: To define the prevalence and determinants of preoperative vitamin D deficiency among adults undergoing spinal fusion. SUMMARY OF BACKGROUND DATA: Vitamin D plays a critical role in establishing optimal bone health, which, in turn, is vital to the success of spinal arthrodesis. Recently, hypovitaminosis D was documented in 43% of adults undergoing any orthopedic surgery. METHODS: Serum 25-hydroxyvitamin D levels were routinely measured in adults undergoing spinal fusion at a single institution. Between January 2010 and March 2011, 313 patients were retrospectively identified for inclusion. Risk factors for vitamin D deficiency (<20 ng/mL) were analyzed using univariate analysis and multivariate logistic regression. RESULTS: The rates of inadequacy (<30 ng/mL) and deficiency were 57% and 27%, respectively. Although 260 patients were diagnosed with degenerative disease (spondylosis), 99 had deformity, and there were 73 revision cases. There was a higher rate of smoking (P = 0.03) and lower age (P < 0.01) in the vitamin D-deficient subset. There was no sex difference. Increasing body mass index (P < 0.01), increasing Neck and Oswestry Disability Index scores (P = 0.03), and lack of vitamin D and/or multivitamin supplementation (P < 0.01) remained predictors of deficiency after multivariate analysis. Those with previous supplementation were older (P < 0.01) and more likely to be at least 50 years old than those without repletion (P < 0.01). CONCLUSION: Our investigation revealed a substantially high prevalence of vitamin D abnormality in the analyzed population. Although advanced age is a well-established risk factor for hypovitaminosis, young adults undergoing fusion should not be overlooked with regard to vitamin D screening; this age bracket is less likely to have been previously supplemented. In the absence of better-recognized determinants, spinal disability indices may also be useful in identifying those with deficiency.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".