CERVICAL DISC DEGENERATION, SEVERITY OF PAIN AND VITAMIN D LEVELS IN PATIENTS WITH CHRONIC NECK PAIN: IS THERE ANY RELATIONSHIP?

Yıl 2020, Cilt: 21 Sayı: 2, 195 - 200, 11.05.2020

Hilal Altaş , Ali Yılmaz

https://doi.org/10.18229/kocatepetip.634480

Öz

OBJECTIVE: Effects of vitamin D on bone metabolism has been long known. We aimed to detect the relationship between vitamin D levels and intervertebral disc degeneration, disc height and severity of pain in patients with chronic neck pain.
MATERIAL AND METHODS: The data of patients who were admitted to neurosurgery polyclinic with chronic neck pain complaints were analyzed retrospectively, whom their vitamin D levels measured, pain severity (VAS) scores ware noted at the time of admission and were radiologically examined with cervical MRI.
RESULTS: Overall, 123 patients were included in the study. There was a significant relationship in terms of VAS scores between the groups divided on the basis of vitamin D levels (p=0.003). There was no statistically significant relationship in terms of age (p=0.180), gender (p=0. 244/p=0.146), and cervical C5-6 disk height (p= 0.299) in the comparison performed within the groups divided on the basis of vitamin D levels.
CONCLUSIONS: In the present study, it was shown that there is a significant relationship between low vitamin D levels and VAS in patients who had cervical disk degeneration and loss of cervical lordosis. We believe that vitamin D deficiency at a metabolic level should be considered in patients who are admitted with chronic neck pain, who do not exhibit neurologic deficits in the examination, and who do not have disc hernia.

Anahtar Kelimeler

Vitamin D, neck pain, cervical disc height

KRONİK BOYUN AĞRISI ŞİKAYETİ OLAN HASTALARDA SERUM D VİTAMİNİ SEVİYELERİ, AĞRI ŞİDDETİ VE SERVİKAL DİSK DEJENERASYONU İLİŞKİLİ MİDİR?

Öz

AMAÇ: Kemik metabolizması üzerinde D vitaminin etkileri uzun zamandır bilinmektedir. Çalışmamızda serum vitamin D seviyeleri ile intervertebral disk dejenerasyonu, disk yüksekliği ve ağrı şiddeti arasındaki ilişkiyi saptamayı hedefledik.
GEREÇ VE YÖNTEM: Beyin cerrahisi polikliniğine kronik boyun ağrısı şikayeti ile başvuran hastaların serum D vitamini seviyeleri, başvuru sırasındaki ağrı şiddeti (VAS) değerleri ve servikal MRG incelemeleri retrospektif olarak değerlendirildi.
BULGULAR: Çalışmaya 123 hasta dahil edildi. Vitamin D düzeylerine göre ayrılan gruplar arasında, VAS skorlarına göre anlamlı fark saptanmıştır (p=0.003). Vitamin D düzeylerine göre ayrılan gruplar arasında yapılan karşılaştırmalarda yaş (p=0.180), cinsiyet (p=0. 244/p=0.146) ve servikal C5-6 disk yüksekliği açısından (p= 0.299) istatistiksel olarak anlamlı bir ilişki bulunamamıştır.
SONUÇ: Çalışmamızda, servikal disk dejenerasyonu ve servikal lordoz kaybı olan hastalarda düşük serum vitamin D seviyeleri ile VAS arasında anlamlı fark saptanmıştır. Metabolik düzeyde D vitamini eksikliğinin, kronik boyun ağrısı ile başvuran, muayenede nörolojik bozukluğu ve disk hernisi olmayan hastalarda göz önünde bulundurulması gerektiğine inanıyoruz.

Anahtar Kelimeler

Vitamin D, neck pain, Magnetic resonance imaging, Cervical disc height

Kaynakça

• 1.Bikle DD: Vitamin D and immune function: understanding common pathways. Current osteoporosis reports. 2009 ;7(2):58-63. 2.Zehnder D, Bland R, Williams MC,et al. Extrarenal expression of 25-hydroxyvitamin D3-1α-hydroxylase. The Journal of ClinicalEndocrinology&Metabolism. 2001;86 (2):888-894.
• 3.Tuffaha M, El Bcheraoui C, Daoud F,et al. Deficiencies under plenty of sun: Vitamin D status among adults in the kingdom of Saudi Arabia, 2013. North American journal of medical sciences. 2015;7(10 ):467-75.
• 4.Heidari B, Shirvani JS, Firouzjahi A, et al. Association between nonspecific skeletal pain and vitamin D deficiency. International journal of rheumatic diseases. 2010;13(3):340-346.
• 5.Pfeifer M, Begerow B, Minne H. Vitamin D and muscle function. Osteoporosis International. 2002; 13(3):187-194.
• 6.Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo clinic proceedings. 2003; 78 (12):1463-70.
• 7.Lane NE, Gore LR, Cummings SR,et al. Serum vitamin D levels and incident changes of radiographic hip osteoarthritis: a longitudinal study. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 1999; 42 (5):854-860.
• 8.Royce PM, Steinmann B. Connective tissue and its heritable disorders: molecular, genetic, and medical aspects. John Wiley & Sons. 2003 159-162.
• 9.Bunout D, Barrera G, Leiva L,et al. Effects of vitamin D supplementation and exercise training on physical performance in Chilean vitamin D deficient elderly subjects. Experimental gerontology. 2006 ; 41 (8):746-752.
• 10.Singh S, Cuzick J, Mesher D, et al. Effect of baseline serum vitamin D levels on aromatase inhibitors induced musculoskeletal symptoms: results from the IBIS-II, chemoprevention study using anastrozole. Breast cancer research and treatment. 2012; 132 (2):625-629. 11.Straube S, Moore AR, Derry S, et al.Vitamin D and chronic pain. Pain. 2009;1 (41):10-13.
• 12.Tetlow LC, Smith SJ, Mawer EB, et al. Vitamin D receptors in the rheumatoid lesion: expression by chondrocytes, macrophages, and synoviocytes. Annals of the rheumatic diseases. 1999; 58 (2):118-121.
• 13.Turner MK, Hooten WM, Schmidt JE, et al. Prevalence and clinical correlates of vitamin D inadequacy among patients with chronic pain. Pain Medicine. 2008; 9(8):979-984.
• 14.Knutsen KV, Madar AA, Brekke M,et al. Effect of vitamin D on musculoskeletal pain and headache A randomized, double-blind, placebo-controlled trial among adult ethnic minorities in Norway.Pain. 2014; 155 (12):2591-2598.
• 15.Lodh M, Goswami B, Mahajan RD, et al. Assessment of vitamin D status in patients of chronic low back pain of unknown etiology. Indian Journal of Clinical Biochemistry. 2015; 30(2):174-179.
• 16.Glover T, Goodin B, Horgas A, et al. Vitamin D, race, and experimental pain sensitivity in older adults with knee osteoarthritis. Arthritis & Rheumatism. 2012;64(12):3926-3935.
• 17.Gruber HE, Hoelscher G, Ingram JA, et al. 1, 25 (OH) 2-vitamin D3 inhibits proliferation and decreases production of monocyte chemoattractant protein-1, thrombopoietin, VEGF, and angiogenin by human annulus cellsinvitro. Spine. 2008;33(7):755-765.
• 18.Werina K, Baum W, Axmann R, et al. Vitamin D receptor regulates TNF-mediated arthritis. Annals of the rheumatic diseases:annrheumdis.2011;14(6):23-31.
• 19.Stoffels K, Overbergh L, Giulietti A, et al. Immune regulation of 25 hydroxyvitamin D3 1α hydroxylase in human monocytes. Journal of Bone and Mineral Research. 2006; 21(1):37-47.
• 20. Stoker GE, Buchowski JM, Bridwell KH, et al. Preoperative vitamin D status of adults undergoing surgical spinal fusion. Global Spine journal. 2013; 38(6):507-515.
• 21.Grob D, Frauenfelder H, Mannion A. The association between cervical spine curvature and neck pain. European Spine Journal. 2007; 16(5):669-678.
• 22.Wynne-Davies R, Walsh W, GormleyJ. Achondroplasia and hypochondroplasia. Clinical variation and spinal stenosis. The Journal of bone and joint surgery. 1981; 63(4):508-515.