Nutritional Depletion in Staged Spinal Reconstructive Surgery

Abstract

For complex patients requiring staged anterior/posterior surgery, TPN appears to significantly lessen the decrease in nutritional parameters. Because depletion of nutritional parameters appears to correlate with an increased likelihood of perioperative infectious complications, use of TPN may result in a decrease of such complications in these patients.

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

“…The justification for this policy is based on two randomized placebo-controlled trials performed by Hu et al (1998) and later, Lapp et al (2001) demonstrating the beneficial effects of nutritional support on the evolution of nutritional parameters in patients undergoing major spinal surgery.…”

“…The documented risk factors for nutritional depletion in patients undergoing major spinal surgery are patient age over 50 y (Lenke et al, 1995;Klein et al, 1996), diagnosis of cerebral palsy (Jevsevar & Karlin, 1993;Hu et al, 1998), circumferential spinal surgery (Lenke et al, 1995;Klein et al, 1996;Hu et al, 1998), and fusion levels equal to or greater than 10 (Jevsevar & Karlin, 1993).…”

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

“…Perioperative nutritional status of adult patients who undergo spine reconstructive surgery has been shown to be an important indicator of surgical morbidity, complication rates and overall surgical success [11][12][13][14][15][16]. 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.…”

“…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.…”

Morbidité de la chirurgie des déformations rachidiennes

“…Les germes les plus fré-quemment rencontrés sont des bacilles Gram négatifs d'origine entérale. Plusieurs facteurs de risque pour ce type de patient ont été mis en évidence [4,[25][26][27][28]. Même s'ils ne sont pas constants d'une étude à l'autre, citons : le retard mental important, l'utilisation d'allogreffe, un tableau de dénutrition important jugé sur un taux de sérum albumine inférieur à 35 g/l et un taux de lymphocytes inférieur à 1500/ml.…”