Lg. Lenke et al., PROSPECTIVE ANALYSIS OF NUTRITIONAL-STATUS NORMALIZATION AFTER SPINALRECONSTRUCTIVE SURGERY, Spine (Philadelphia, Pa. 1976), 20(12), 1995, pp. 1359-1367
Study Design. A prospective analysis of nutritional status after surge
ry in 57 spinal reconstructive surgery patients. Objectives. To determ
ine the length of time required for patients to return to their preope
rative nutritional baseline and to investigate risk factors for patien
ts with prolonged normalization. Summary of Background Data. The perio
perative nutritional status of spinal reconstructive surgery patients
appears to be an important parameter of surgical morbidity, complicati
on rates (especially wound healing), patient acceptance, and overall s
urgical success. Methods. The nutritional parameters of albumin, preal
bumin, total protein, transferrin, and the absolute. lymphocyte count
were investigated before surgery and at various time points after surg
ery. Results. Forty-four patients (Group A) with an average 6.4 fusion
levels returned to their preoperative baseline nutritional values by
6 weeks after surgery, whereas 13 patients (Group B) with a statistica
lly increased number of fusion levels of 13.8 (P = 0.0009) took 12 wee
ks or longer to return to their preoperative baseline. Risk factors fo
r prolonged normalization (Group B) included increased total number ef
fusion levels, especially 10 or more (P < 0.05); patients-undergoing c
ircumferential fusions (P < 0.05); and, to a lesser extent, older pati
ents undergoing multiple fusion levels (P = 0.055). Conclusions. These
data are important when counseling spinal reconstructive surgery pati
ents before surgery and provides information to those patients who may
benefit from perioperative nutritional supplementation.