PROSPECTIVE ANALYSIS OF NUTRITIONAL-STATUS NORMALIZATION AFTER SPINALRECONSTRUCTIVE SURGERY

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.