The Relationship of Vitamin D Insufficiency with Low-Energy Fractures in Children

BACKGROUND: Approximately 50% of the world population are suffering from Vitamin D insufficiency. Vitamin D is one of the steroid hormones, which is a fat soluble vitamin that has a critical role in maintaining the homeostasis of bones. Low-energy fractures are defined as falling from the level of standing height or even less that usually should not result in fractures. Another study that was done in Jeddah on a sample of 510 children between the age of 4–15 taken in the pediatric clinic at Jeddah Clinic Hospital-Kandarah. 59% had relative deficiency, and 27% had a deficiency in 25-hydroxyvitamin D. AIM: Therefore, this research is conducted to collect more evidences to assess the association between vitamin D level and low-energy fractures in children. METHODS: The study group consisted of 14 children aged 3–15 years old with low-energy fractures and the control group consisted of 24 children in the same age without fractures. Vitamin D level was measured in each one of them and X-ray was obtained from the cases to prove the presence of low-energy fracture. The analysis plan that was used in this research is Fisher’s exact test to overcome the small sample size. RESULTS: Vitamin D levels were found deficient in four cases, and eight of them were insufficient. Whereas, the normal level of Vitamin D was found in only two of the cases. On the other hand, in the control group the level of Vitamin D was deficient in four participants, and 15 others were found to be insufficient. Also, five of the participants were found to have a normal Vitamin D level. According to the results, low levels of Vitamin D were observed in both groups. A total of 23 out of 38 children enrolled in the study were found to have an insufficient Vitamin D level. The result of p = 0.718 which is not significant to prove the correlation between Vitamin D insufficiency and low-energy fractures. CONCLUSION: In conclusion, this study did not show any relation between Vitamin D level and the presence of low energy fracture. Future studies are required to include more subjects and centers to their study or to compare the low energy fracture and high energy fracture in term of Vitamin D level

SPINE20 A global advocacy group promoting evidence-based spine care of value

PURPOSE: The Global Burden of Diseases (GBD) Studies have estimated that low back pain is one of the costliest ailments worldwide. Subsequent to GBD publications, leadership of the four largest global spine societies agreed to form SPINE20. This article introduces the concept of SPINE20, the recommendations, and the future of this global advocacy group linked to G20 annual summits. METHODS: The founders of SPINE20 advocacy group coordinated with G20 Saudi Arabia to conduct the SPINE20 summit in 2020. The summit was intended to promote evidence-based recommendations to use the most reliable information from high-level research. Eight areas of importance to mitigate spine disorders were identified through a voting process of the participating societies. Twelve recommendations were discussed and vetted. RESULTS: The areas of immediate concern were "Aging spine," "Future of spine care," "Spinal cord injuries," "Children and adolescent spine," "Spine-related disability," "Spine Educational Standards," "Patient safety," and "Burden on economy." Twelve recommendations were created and endorsed by 31/33 spine societies and 2 journals globally during a vetted process through the SPINE20.org website and during the virtual inaugural meeting November 10-11, 2020 held from the G20 platform. CONCLUSIONS: This is the first time that international spine societies have joined to support actions to mitigate the burden of spine disorders across the globe. SPINE20 seeks to change awareness and treatment of spine pain by supporting local projects that implement value-based practices with healthcare policies that are culturally sensitive based on scientific evidence