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

• Published in: Clinics in orthopedic surgery Vol. 9; no. 3; pp. 317 - 324
• Main Authors: Lee, Gun Woo, Yang, Han Seok, Yeom, Jin S., Ahn, Myun-Whan
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Orthopaedic Association 01.09.2017; 대한정형외과학회
• Subjects: Ascorbic Acid - therapeutic use; Female; Humans; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - surgery; Male; Middle Aged; Original; Pain Measurement; Pain, Postoperative - prevention & control; Radiography; Spinal Fusion - methods; Spinal Stenosis - surgery; Treatment Outcome; Vitamins - therapeutic use; 정형외과학; Treatment outcome; Ascorbic acid; Posterior lumbar interbody fusion; Spinal stenosis
• ISSN: 2005-291X; 2005-4408; 2005-4408
• DOI: 10.4055/cios.2017.9.3.317

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. 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. 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. 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.