Calcium and vitamin D for controlling curve progression in adolescent idiopathic scoliosis – further review with Finite Element Analysis (FEA) for a randomized double-blinded placebo-controlled trial
Refereed conference paper presented and published in conference proceedings


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AbstractIntroduction
Adolescent Idiopathic Scoliosis (AIS) is associated with low bone mass which has been reported to be an independent and significant prognostic factor for curve progression in AIS. Given that AIS subjects have low serum 25(OH)Vit-D levels and low dietary calcium (Ca) intake, it will be logical to evaluate whether Ca plus Vit-D (Ca+Vit-D) supplementation could improve bone health and prevent curve progression in AIS.
Objective(s)
To evaluate if Ca+Vit-D supplementation could improve bone strength and prevent curve progression in AIS.
Method(s)
This was a randomized double-blinded placebo-controlled trial on 330 AIS girls (11-14 years old, femoral neck aBMD Z-scores<0 and Cobb angle>15°) randomized to Group1 (placebo), Group2 (600mg Calcium+400IUVit-D3/day) and Group3 (600mg Calcium +800IUVit-D3/day). Treatment duration was 2-yr. At baseline and 24-month, Finite Element Analysis(FEA) on HR-pQCT parameters, serum 25(OH)Vit-D and dietary calcium intake were assessed. Evaluation of curve progression defined as Cobb increase ≥ 6° was conducted according to SRS guidelines at the Latest Follow-up.
Result(s) and discussions
270(81.8%) subjects completed the study. The increase in FEA bone strength parameters (stiffness (kN/mm), failure-load (N) and apparent-modulus (MPa)) at 24-month were significantly greater in the Treatment Group (p<0.05). At the Latest Follow-up (N=132), 21·7% in Group3 and 24·4% in Group2 had curve progression ≥ 6° as compared with 46·7% in Group1 (p<0.05). Increase in FEA parameters, namely failure load and apparent modulus, were significant
protective factors against curve progression (p<0.05). Ca+Vit-D supplementation was more effective in preventing curve progression for those with low baseline serum 25(OH)Vit-D levels ( ≤ 50nmol/L).
Conclusion(s) and significance
The results provide strong evidences that daily 600mg calcium+400/ 800IUVit-D3 improves bone strength and prevents curve progression in female AIS subjects with low bone mass especially for those with low baseline 25(OH)Vit-D levels and hence can be considered as a therapeutic option for preventing curve from progression to bracing or surgical thresholds.
This study was partially funded by an Investigator-initiated Research Grant from Pfizer Inc.
All Author(s) ListTsz Ping Lam, Benjamin Hon Kei Yip, Fiona Wai Ping Yu, Nelson Leung Sang Tang, Kenneth Kin Wah To, Kwong Man Lee, Wayne YW Lee, Bobby Kin Wah Ng, Alec Lik Hang Hung, Yong Qiu , Jack Chun Yiu Cheng
Name of ConferenceThe 12th Meeting of International Research Society on Spinal Deformities (IRSSD)
Start Date of Conference14/06/2018
End Date of Conference16/06/2018
Place of ConferenceUtrecht
Country/Region of ConferenceNetherlands
Proceedings TitleScoliosis and Spinal Disorders
Year2018
Month6
Volume Number13
Issue NumberSupp 1
Pages8 - 8
ISSN2397-1789
LanguagesEnglish-United Kingdom

Last updated on 2018-22-11 at 11:41