Combined vitamin K2 and D3 therapy improves endoscopic fusion outcomes in osteoporotic lumbar degenerative disease: a prospective study

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.