Combined vitamin K2 and D3 therapy improves endoscopic fusion outcomes in osteoporotic lumbar degenerative disease: a prospective study
Sci Rep. 2025 May 2;15(1):15422. doi: 10.1038/s41598-025-99922-9.
Yanan Wang 1, Yidi Wang 1, Fengming Wang 1, Zhenyu Wang 1, Ran Sun 1, Xiaoling Huang 1, Song Fu 2
The efficacy of combined vitamin K2 and D3 therapy on bone fusion outcomes following endoscopic lumbar surgery in osteoporotic patients remains unclear. This prospective study investigated the effects of combined vitamin K2 and D3 supplementation on fusion outcomes in osteoporotic patients undergoing endoscopic lumbar interbody fusion.
Seventy-one patients were divided into two groups:
- the experimental group (n = 36) received vitamin K2 (45 mg/day), vitamin D3 (250 IU/day), and calcium (1.2 g/day),
- while the control group (n = 35) received only vitamin D3 (250 IU/day) and calcium (1.2 g/day)
for 6 months postoperatively. The primary outcome was fusion rate assessed by CT and dynamic radiography.
At 6 months postoperatively, the VK2 + VD3 group showed significantly higher complete fusion rates compared to the control group (91.67% vs. 74.29%, P = 0.044). Serum P1NP levels were significantly higher in the VK2 + VD3 group at 3 months postoperatively (P = 0.001). Both groups showed comparable improvements in clinical outcomes (JOA-BPEQ and ODI scores). While BMD changes were not statistically significant between groups, the VK2 + VD3 group showed a trend toward BMD improvement. These findings suggest that combined vitamin K2 and D3 supplementation may enhance early fusion outcomes in osteoporotic patients undergoing endoscopic lumbar interbody fusion, potentially offering a simple and effective adjunct therapy for improving surgical outcomes.
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