Analysis of nutritional parameters in idiopathic scoliosis patients after major spinal surgery

Abstract

Objective: The aim of the study is to investigate the evolution of nutritional parameters after major spinal surgery in patients with idiopathic scoliosis. Methods: This retrospective study included 31 patients with a mean age of 18 y, diagnosed with idiopathic scoliosis. The following variables were analyzed: demographic, surgical (type, number of fused segments, duration, and blood loss), nutritional assessment (proteins, albumin, prealbumin, transferrin, lymphocytes, and body mass index), and duration of hospitalization at different time points. Statistical analyses were performed with the SPSS 6.1 software. Results: Before surgery, nutritional status was normal in all patients. At 24-48 h after surgery, statistically significant decrease with respect to preoperative values was recorded for all the parameters studied: proteins (Po0.001), albumin (Po0.001), prealbumin (Po0.01), transferrin (Po0.001), and lymphocytes (Po0.001). Conclusion: Our results showed a significant postoperative decrease in the nutritional parameters analyzed in a previously wellnourished population considered to be at low risk for nutritional depletion.

Anthropometric characteristics, high prevalence of undernutrition and weight loss: impact on outcomes in patients with adolescent idiopathic scoliosis after spinal fusion

“…This finding is evidenced by the fact that over one quarter of these preoperatively well nourished patients, had a BMI Z-score\-2 at hospital discharge. Additionally, serum albumin, total protein and haemoglobin levels were below normal limits in the majority of patients; in a mixed adolescent-adult idiopathic scoliosis cohort, Lalueza et al [17] reported similar observations. Serum albumin (i.e.…”

“…Data were incomplete for the blood profile levels under analysis, in addition to weight measurements at hospital discharge, in five cases. However, our patient sample with available blood profile measurements is still larger than those reported in existing studies [17]. Other potentially useful markers of nutritional status such as body composition measurements were not collected in this series.…”

“…Despite the clear need to nutritionally support these patients after surgery, there are feeding challenges as outlined in the current study, and consensus on an optimal approach is lacking. More studies are necessary to establish the importance of PN support in adolescents at low nutritional risk undergoing major spinal surgery [17]. The safety, clinical benefit, feasibility and cost-effectiveness of post-pyloric feeding (e.g.…”

“…However, studies examining paediatric scoliosis populations are lacking, and no study of which we are aware, has examined nutritional status in an AIS cohort exclusively, after spinal fusion. Earlier studies have mainly included mixed adolescent-adult populations [17], or adult populations with a wide variety of pathologies, undergoing different spinal surgical procedures [11][12][13][14]. The effect of preoperative underweight status on perioperative outcomes in AIS has been previously reported [7], however, no study has yet quantified postoperative weight loss, or established its effect on outcomes in these already very thin patients.…”

Enhanced recovery after surgery (ERAS) and its applicability for major spine surgery

“…Major spinal surgery can be associated with significant post-operative decrease in nutritional parameters in a population that was well-nourished prior to surgery [53]. The body has higher basal energy requirements after major surgery and this can increase morbidity, delay wound healing, and increase hospital length of stay [54].…”