Risk factors of vitamin D deficiency following corrective spinal surgery in adolescent idiopathic scoliosis: A narrative review

Adolescent idiopathic scoliosis (AIS) is a common rigid structural spinal deformity with unknown etiology. It has been associated with low bone mineral density and osteopenia. Vitamin D has an essential role in bone health and mineralization. So it is assumed that vitamin D deficiency (VDD) is associated with the onset and development of AIS. Risk factors of VDD in general population had been introduced and discussed widely but those involved in patients after corrective spinal surgery are debated. Here we review the most dominant risk factors associated with VDD in AIS patients following corrective spinal surgery. Preoperative VDD is probably the main risk factor of postoperative VDD. Female gender, eating disorders, dressing habits, physical inactivity, and increased bone turnover are the most important contributors of preoperative VDD. ICU admission, pain, medications, surgical complications, delirium, stress response, and bracing are probably the main risk factors of VDD postoperatively. The risk factor modifications and nutritional supplementation could profoundly impact surgical outcomes in this high-risk group of patients.