Prospective analysis of nutritional status normalization after spinal reconstructive surgery

Study Design. A prospective analysis of nutritional status after surgery in 57 spinal reconstructive surgery patients.Objectives. To determine the length of time required for patients to return to their preoperative nutritional baseline and to investigate risk factors for patients with prolonged normalization.Summary of Background Data. The perioperative nutritional status of spinal reconstructive surgery pa¬tients appears to be an important parameter of surgical morbidity, complication rates (especially wound heal¬ing), patient acceptance, and overall surgical success.Methods. The nutritional parameters of albumin, prealbumin, total protein, transferrin, and the absolute lymphocyte count were investigated before surgery and at various time points after surgery.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 statistically increased number of fusion levels of 13.8 (P = 0.0009) took 12 weeks or longer to return to their preoperative baseline. Risk factors for prolonged normalization (Group B) included increased total number of fusion levels, especially 10 or more (P< 0.05); patients undergoing circumferential fusions (P< 0.05); and, to a lesser extent, older patients undergoing multiple fusion levels (P = 0.055).Conclusions. These data are important when counseling spinal reconstructive surgery patients before surgery and provides information to those patients who may benefit from perioperative nutritional supplementation.