Document Detail

Dual pathology as a result of spinal stenosis and vitamin B12 deficiency.
MedLine Citation:
PMID:  21553339     Owner:  NLM     Status:  MEDLINE    
Vitamin B12 deficiency can confound the clinical assessment of patients presenting with features of spinal disorders. Speciality practice within spinal surgery may lead the clinician to a focus upon spinal explanations for symptoms and that belief may be reinforced by supporting imaging. In the presence of mainly sensory symptoms consideration and exclusion of non surgical causes needs to occur. This study aimed at identifying the prevalence of vitamin B12 deficiency; the presence of dual pathology on imaging performed; the implementation of replacement therapy and their subsequent clinical response as perceived by patients. This was performed through a retrospective review of patients presenting to specialist spine out-patient clinics over a 4-year period via access to pathology reports followed by a telephone survey. 457 patients were investigated of which 8.5% were vitamin B12 deficient. 70% of patients had repeat levels and 31% continued to be deficient. 26% of these patients were not placed on any supplemental therapy. 72% of patients on treatment had self perceived improved outcomes as compared with 55% not on treatment. 73% of patients underwent MRI/CT imaging. 59% of which had evidence of spinal stenosis. In older patients with sensory symptoms, the coexistence of B12 deficiency should be considered. Detection of deficiency with consequent treatment results in better global outcomes than no treatment. Unless the correct blood test is done, the pathology will remain undetected, and patients may continue with their primary symptoms despite high-risk spinal surgical procedures.
Mohammed Shakil Patel; Zurqa Rasul; Philip Sell
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Publication Detail:
Type:  Journal Article     Date:  2011-05-08
Journal Detail:
Title:  European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society     Volume:  20     ISSN:  1432-0932     ISO Abbreviation:  Eur Spine J     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-05     Completed Date:  2012-07-19     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  9301980     Medline TA:  Eur Spine J     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  2247-51     Citation Subset:  IM    
Orthopaedic Department, Leicester General Hospital, Gwendelon Road, Leicester LE5 4PW, UK.
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MeSH Terms
Aged, 80 and over
Middle Aged
Retrospective Studies
Spinal Stenosis / complications*,  drug therapy
Treatment Outcome
Vitamin B 12 / therapeutic use*
Vitamin B 12 Deficiency / complications*,  drug therapy
Reg. No./Substance:
68-19-9/Vitamin B 12

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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