Original Article

Vitamin D deficiency in Scheuermann’s disease is associated with increased adverse outcomes

¹ John Sealy School of Medicine, 301 University Blvd, The University of Texas Medical Branch, Galveston, TX 77555, USA
² Department of Orthopaedic Surgery, Louisiana State University, New Orleans, LA 70112, USA

^* Corresponding author: smudig@lsuhsc.edu

Received: 20 February 2024
Accepted: 20 March 2024

Abstract

Introduction: Scheuermann’s disease is a diagnosis of hyperkyphosis commonly encountered in pediatric patients. Studies in animal models suggest an association with vitamin D deficiency, however, extensive studies have not been performed in humans. This study analyzes the role of vitamin D deficiency on unfavorable results in patients with Scheuermann’s disease. Methods: The TriNetX database was utilized to perform a retrospective analysis. Patients in the United States aged 0–18 years with Scheuermann’s disease were identified using International Classification of Diseases, Tenth Revision (ICD-10) codes and categorized into those with and without a diagnosis of vitamin D deficiency. Comparison of patient groups depending on age, sex, ethnic origin, prior diagnosis of fibromyalgia, anxiety disorder, myositis, and major depressive disorder. Statistical analysis was conducted to identify the association between vitamin D levels and unfavorable results including pain, depression, suicide attempt, emergency department (ED) consult, hospitalization, and procedures on the spine or spinal cord. Results: In total, 11,277 patients were identified, 39% of whom had a concurrent diagnosis of scoliosis. A total of 1,024 (9.08%) were deficient in vitamin D. Patients with vitamin D deficiency had greater odds of pain (P < 0.0001), depression (P < 0.0001), suicide attempt (P = 0.0021), ED visits (P = 0.0246), and hospital admission (P < 0.0015). Conversely, patients with vitamin D deficiency had decreased odds of surgery on the spine or spinal cord (P = 0.0009). Conclusion: Vitamin D deficiency is associated with an elevated risk of pain, depression, suicide attempts, ED visits, and hospitalization. Our analysis highlights the need for more research to study the effect of vitamin D on Scheuermann’s disease.

Level of evidence: Level III, Prognostic