Abstract
The efficacy of combined vitamin K(2) and D(3) therapy on bone fusion outcomes following endoscopic lumbar surgery in osteoporotic patients remains unclear. This prospective study investigated the effects of combined vitamin K(2) and D(3) 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 K(2) (45 mg/day), vitamin D(3) (250 IU/day), and calcium (1.2 g/day), while the control group (n = 35) received only vitamin D(3) (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 VK(2) + VD(3) 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 VK(2) + VD(3) 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 VK(2) + VD(3) group showed a trend toward BMD improvement. These findings suggest that combined vitamin K(2) and D(3) 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.