The Efficacy of Vitamin C on Postoperative Outcomes after Posterior Lumbar Interbody Fusion: A Randomized, Placebo-Controlled Trial.
10.4055/cios.2017.9.3.317
- Author:
Gun Woo LEE
1
;
Han Seok YANG
;
Jin S YEOM
;
Myun Whan AHN
Author Information
1. Spine Center and Department of Orthopaedic Surgery, Yeungnam University Medical Center, Daegu, Korea. gwlee1871@gmail.com
- Publication Type:Original Article
- Keywords:
Ascorbic acid;
Spinal stenosis;
Posterior lumbar interbody fusion;
Treatment outcome
- MeSH:
Ascorbic Acid*;
Double-Blind Method;
Follow-Up Studies;
Humans;
Outcome Assessment (Health Care);
Pain, Postoperative;
Pathology;
Prospective Studies;
Spinal Stenosis;
Spine;
Treatment Outcome;
Vitamins*
- From:Clinics in Orthopedic Surgery
2017;9(3):317-324
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Vitamin C has critical features relavant to postoperative pain management and functional improvement; however, no study has yet evaluated the effectiveness of vitamin C on improving the surgical outcomes for spine pathologies. Thus, this study aimed to explore the impact of vitamin C on postoperative outcomes after single-level posterior lumbar interbody fusion (PLIF) for lumbar spinal stenosis in prospectively randomized design. We conducted a 1-year prospective, randomized, placebo-controlled, double-blind study to evaluate the impact of vitamin C on the postoperative outcomes after PLIF surgery. METHODS: A total of 123 eligible patients were randomly assigned to either group A (62 patients with vitamin C) or group B (61 patients with placebo). Patient follow-up was continued for at least 1 year after surgery. The primary outcome measure was pain intensity in the lower back using a visual analogue scale. The secondary outcome measures were: (1) the clinical outcome assessed using the Oswestry Disability Index (ODI); (2) the fusion rate assessed using dynamic radiographs and computed tomography scans; and (3) complications. RESULTS: Pain intensity in the lower back was significantly improved in both groups compared with preoperative pain intensity, but no significant difference was observed between the 2 groups over the follow-up period. The ODI score of group A at the third postoperative month was significantly higher than the score of group B. After the sixth postoperative month, the ODI score of group A was slightly higher than the score of group B; however, this difference was not significant. The fusion rates at 1 year after surgery and the complication rates were not significantly different between the 2 groups. CONCLUSIONS: Postoperative pain intensity, the primary outcome measure, was not significantly different at 1 year after surgery between the 2 groups. However, vitamin C may be associated with improving functional status after PLIF surgery, especially during the first 3 postoperative months.
