Focused Perioperative Nutritional Supplementation Reduces Wound Complications in Patients Undergoing Spinal Fusion Surgery

Abstract

Study design: Retrospective cohort study.

Objective: To evaluate intensive postoperative nutritional supplementation on wound healing complications and outcomes after spinal fusion surgery.

Background: Poor nutritional status leads to inferior postoperative outcomes by increasing mortality and predisposing patients to infection and wound-healing complications. While perioperative nutritional supplementation has shown promise in mitigating these risks, there is a paucity of literature regarding specific nutritional routines in spinal fusion surgery.

Materials and methods: A retrospective analysis was conducted on patients who underwent spinal fusion surgery between 2019 and 2022. Demographic and nutritional data, including preoperative prealbumin (PAB) levels and postoperative supplemental diet, were examined. Primary endpoints included wound complications, with secondary outcomes assessing Oswestry Disability Index (ODI) and Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Health (PH) scores. Statistical analyses included unpaired t tests and χ 2 /Fischer exact tests with significance set at P <0.05.

Results: Patients receiving the supplemental diet (n=229) demonstrated fewer wound complications (7% vs . 21%, P =0.004) and reoperations (3% vs . 11%, P =0.016) compared with those without supplementation (n=56). No significant differences were observed in preoperative or postoperative PROMIS PH or ODI scores. Patients with normal preoperative PAB had more wound complications without the supplemental diet (5% vs . 18%, P =0.025). A similar trend was seen in the patients with low preoperative PAB (12% vs . 26%, P =0.12).

Conclusion: Postoperative nutritional supplementation significantly reduces wound complications after spinal fusion surgery in a cost-effective manner. This study underscores the modifiability of certain perioperative risk factors and suggests that nutritional strategies can mitigate potential complications.

Keywords: nutrition supplementation; patient complications; patient outcomes; perioperative optimization; plastic surgery diet; spine; spine surgery; wound healing.