• Shin Oe, Jun Watanabe, Tatsuya Akai, Tomomi Makino, Midori Ito, Yu Yamato, Tomohiko Hasegawa, Go Yoshida, Tomohiro Banno, Hideyuki Arima, Yuki Mihara, Hiroki Ushirozako, Tomohiro Yamada, Koichiro Ide, Yuh Watanabe, Kenta Kurosu, Keiichi Nakai, and Yukihiro Matsuyama.
• Department of Orthopedic Surgery and Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, Hamamatsu, Japan.
• Spine. 2022 Mar 1; 47 (5): 387395387-395.

Study DesignA prospective nutritional intervention study for adult spinal deformity (ASD) patients.ObjectiveTo investigate how a nutritional intervention affects the incidence of postoperative medical complications and the nutritional status.Summary Of Background DataThe medical complication rate in ASD surgery is very high, and one risk factor is malnutrition. Nutritional intervention may improve the patient's nutritional status and reduce risk, but this is unexplored regarding ASD surgery.MethodsMalnourished patients (i.e., a prognostic nutritional index [PNI] score of <50) scheduled for surgery after November 2018 (Group I) received nutritional intervention consisting of nutritional guidance and supplements on the surgery day. The medical complication rates between Group I and Group NI (malnourished patients who underwent surgery between January 2014 and October 2018; historical controls) were evaluated. The nutritional status courses of Group I and Group NI2 (patients who did not participate in nutritional intervention after November 2018) were assessed.ResultsGroup I had 24 patients in (mean age, 70 yr), and Group NI had 69 patients (mean age, 68 yr). The mean intervention duration was 41 days. The preoperative PNI score did not differ between the groups, but there was a significant difference in medical complications incidences (Group I: 25%; Group NI: 53.6%; P = 0.015). The nutritional status significantly deteriorated in Group I (PNI: 47-45; P = 0.011) and Group NI2 (61 patients; mean age, 68 yr; PNI: 52-48; P = 0.000), but the PNI changes were significantly smaller in Group I (ΔPNI: Group I: -1.9, Group NI 2: -3.5; P = 0.027).ConclusionNutritional intervention with guidance and supplements reduced postoperative medical complications in malnourished patients. The nutritional status of ASD patients requiring surgery also naturally worsened, suggesting that ASD may contribute to malnutrition. Nutritional intervention may reduce the nutritional status deterioration.Level of Evidence: 3.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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