Clin Orthop Surg.  2017 Sep;9(3):317-324. 10.4055/cios.2017.9.3.317.

The Efficacy of Vitamin C on Postoperative Outcomes after Posterior Lumbar Interbody Fusion: A Randomized, Placebo-Controlled Trial

Affiliations
  • 1Spine Center and Department of Orthopaedic Surgery, Yeungnam University Medical Center, Daegu, Korea. gwlee1871@gmail.com
  • 2Spine Center and Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

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.

Keyword

Ascorbic acid; Spinal stenosis; Posterior lumbar interbody fusion; Treatment outcome

MeSH Terms

Ascorbic Acid/*therapeutic use
Female
Humans
Lumbar Vertebrae/diagnostic imaging/*surgery
Male
Middle Aged
Pain Measurement
Pain, Postoperative/prevention & control
Radiography
Spinal Fusion/*methods
Spinal Stenosis/surgery
Treatment Outcome
Vitamins/*therapeutic use
Vitamins
Ascorbic Acid

Figure

  • Fig. 1 Flow diagram of patient enrollment.


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