title: Prospective analysis of nutritional status normalization after spinal reconstructive surgery.
abstract: METHODS
  A prospective analysis of nutritional status after surgery in 57 spinal reconstructive surgery patients.
  
  
  OBJECTIVE
  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.
  
  
  BACKGROUND
  The preoperative nutritional status of spinal reconstructive surgery patients appears to be an important parameter of surgical morbidity, complication rates (especially wound healing), patient acceptance, and overall surgical success.
  
  
  METHODS
  The nutritional parameters of albumin, pre-albumin, 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.
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, Barnes Hospital, St. Louis, Missouri, USA.
authors.forename: L G
authors.initials: LG
authors.lastname: Lenke
authors.forename: K H
authors.initials: KH
authors.lastname: Bridwell
authors.forename: K
authors.initials: K
authors.lastname: Blanke
authors.forename: C
authors.initials: C
authors.lastname: Baldus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011184:Postoperative Period; D011228:Prealbumin / Q000378:metabolism; D011446:Prospective Studies; D011506:Proteins / Q000378:metabolism; D012016:Reference Values; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D013123:Spinal Fusion; D013131:Spine / Q000601:surgery*; D013997:Time Factors; D014168:Transferrin / Q000378:metabolism
chemical_list: D011228:Prealbumin; D011506:Proteins; D012709:Serum Albumin; D014168:Transferrin