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Vitamin D Deficiency and Surgical Outcome in Adolescent Idiopathic Scoliosis in Low Socioeconomic Status in Rural India

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Journal of Clinical Orthopaedics | Vol 10 | Issue 1 | January-June 2025 | page: 8-13 | Ujjwal Kanti Debnat, Shweta Bhyri, Biplab Maji, Alaaeldin Ahmad, Shubhadip Chakraborty, Joydeep Das

DOI: https://doi.org/10.13107/jcorth.2025.v10i01.703

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2025; The Author(s).

Submitted Date: 13 Feb 2025, Review Date: 15 Mar 2025, Accepted Date: ?? Apr 2025 & Published Date: 30 Jun 2025

Author: Ujjwal Kanti Debnat [1], Shweta Bhyri [2], Biplab Maji [2], Alaaeldin Ahmad [2], Shubhadip Chakraborty [1], Joydeep Das [1]

[1] Department of Orthopaedics, Jagannath Gupta Institute of Medical Sciences (JIMSH), Budge Budge, Kolkata, India
[2] Department of Paediatrics, Jagannath Gupta Institute of Medical Sciences (JIMSH), Budge Budge, Kolkata, India

Address of Correspondence

Dr. Ujjwal K Debnath,
Consultant, Orthopaedics & Spine Surgeon, Professor Department of Orthopaedics, Jagannath Gupta Institute of Medical Sciences (JIMSH), Budge Budge, Kolkata, India
India.
E-mail: debs10uk@gmail.com

Abstract

Introduction: Patients with adolescent idiopathic scoliosis (AIS) have a higher prevalence of Vitamin D deficiency compared with healthy peers. Hypothesis: Vitamin D deficiency in AIS patients does not have a good functional outcome after posterior instrumented corrective spinal fusion.
Materials and Methods: A prospective consecutive study of 62 children who underwent surgery for AIS had pre-operative measurement of Vitamin D levels [serum 25-hydroxyvitamin D (ng/mL)]. Post-operative AIS patients were followed up for 2 years after surgery. Data on the history of back pain, socioeconomic status, curve magnitude, age, and gender were recorded. Patients were categorized based on Vitamin D level: deficient (<20 ng/mL), insufficient (20–29 ng/mL), or sufficient (≥30 ng/mL). The correlation between Vitamin D levels and Scoliosis Research Society (SRS)-22 scores was analyzed using multivariable analysis and pair-wise comparisons using Tukey method.
Results: Sixty-two AIS patients (47 Females and 15 Males) were enrolled who underwent posterior instrumented spine fusion. The mean age at surgery was 15.24 ± 4.5 years. Major coronal curves had a mean of 68.08 ± 12° preoperatively and 12.19 ± 4.2° postoperatively. It was found that 35 (56.45%) of patients were Vitamin D deficient, 23 (37.09%) were insufficient, and 4 (6.45%) were sufficient. Although there was no correlation between Vitamin D level and pain, mental health, or satisfaction domains (P > 0.05), Vitamin D-deficient patients were found to be younger than 18 years of age (P < 0.001) and had lower SRS-22 function (P = 0.010), Self-image (P = 0.049), and total scores (P = 0.007).
Conclusion: AIS patients with Vitamin D deficiency (<20 ng/mL) are more likely to be younger at the time of surgery, and report lower function, self-image, and total SRS-22 scores postoperatively.
Keywords: Adolescent Idiopathic Scoliosis, Posterior Spinal Fusion, Vitamin D Deficiency

References

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How to Cite this article: Debnat UK, Bhyri S, Maji B, Ahmad A, Chakraborty S, Das J. Vitamin D Deficiency and Surgical Outcome in Adolescent Idiopathic Scoliosis in Low Socioeconomic Status in Rural India. Journal of Clinical Orthopaedics January-June 2025;10(1):00-00.

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Bracing for Impact – Bracing in Adolescent Idiopathic Scoliosis

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Journal of Clinical Orthopaedics | Vol 8 | Issue 1 |  Jan-Jun 2023 | page: 38-40 | Kshitij Chaudhary

DOI: 10.13107/jcorth.2023.v08i01.561

Author: Kshitij Chaudhary [1]

[1] Orthopaedic Spine Surgeon, Department of Orthopaedics, P.D. Hinduja National Hospital and Research Centre,
Mumbai, Maharashtra, India..

Address of Correspondence
Dr. Kshitij Chaudhary,
1417, OPD Building, PD hinduja Hospital and Research Center, Veer Savarkar Marg, Mahim, Mumbai, 400016, India.
E-mail: chaudhary.kc@gmail.com

Abstract

Bracing plays a vital role in the non-operative treatment of adolescent idiopathic scoliosis (AIS), especially when detected early. Recent high-quality studies confirm that bracing can alter the natural progression of a curve, potentially preventing the need for surgery. The concept is based on the ability of external force to guide spine growth, which has been experimentally proven. However, bracing cannot straighten the spine; its primary goal is to halt the curve’s progression. The evidence for bracing is strong, with studies showing that approximately two-thirds of AIS curves can be controlled through bracing. However, there are concerns about the broad application of bracing indications, potentially leading to unnecessary treatment for some patients. Identifying the 25% of patients who will benefit from bracing remains a challenge. Bracing is most effective when applied to curves between 25-45° during the rapid growth phase, but compliance is crucial for success. The choice of brace type matters less than its quality and corrective effect. The practice of bracing requires a close orthotist-surgeon relationship, and follow-up visits are essential to monitor progress. Ultimately, bracing remains a valuable non-surgical option for AIS, but careful patient selection and close monitoring are necessary for optimal results.

Keywords: Brace, Adolescent idiopathic scoliosis.

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How to Cite this article: Chaudhary K. Bracing for Impact – Bracing in Adolescent Idiopathic Scoliosis. Journal of Clinical Orthopaedics Jan-Jun 2023;8(1):38-40.

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