Preoperative undernutrition in older people with adult spinal deformities is associated with worse postoperative sagittal vertical axis

IF 1.4 4区医学 Q3 ORTHOPEDICS

Journal of Orthopaedic Science Pub Date : 2026-03-01 Epub Date: 2025-07-28 DOI:10.1016/j.jos.2025.07.001

Jun Ouchida , Hiroaki Nakashima , Sadayuki Ito , Naoki Segi , Tokumi Kanemura , Tetsuya Ohara , Taichi Tsuji , Ryuichi Shinjo , Ippei Yamauchi , Yukihito Ode , Shiro Imagama

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引用次数: 0

Abstract

Background

The impact of preoperative nutritional status on postoperative clinical outcomes in older adults undergoing surgery for adult spinal deformity (ASD) remains unclear. This study aimed to investigate the association between preoperative nutritional status and postoperative clinical and radiological outcomes in patients undergoing surgery for ASD.

Methods

A total of 117 patients (mean age: 73.3 ± 5.4 years; 77 women) who underwent fusion of ≥3 vertebrae for ASD were retrospectively enrolled from a multicenter database. Nutritional status was assessed using the Controlling Nutritional Status (CONUT) scale, which is based on serum albumin, total lymphocyte count, and total cholesterol levels, with scores ranging from 0 to 10. Patients were classified into two groups according to their nutritional status: the undernutrition (UN) group (CONUT score ≥2) and the normal nutrition (N) group (CONUT score 0–1). Multivariate regression analysis was performed to identify independent predictors of postoperative sagittal alignment deterioration.

Results

The N group included 67 patients, while the UN group included 50 patients. At 2 years postoperatively, the UN group exhibited a significantly greater sagittal vertical axis (SVA) (56.5 ± 47.5 mm vs. 44.2 ± 40.2 mm, P = 0.007) and a smaller spino-femoral angle (SFA) (194.4 ± 19.3° vs. 202.6 ± 19.2°, P = 0.029) compared to the N group. Multivariate analysis revealed that preoperative undernutrition was an independent predictor of postoperative SVA deterioration.

Conclusions

Preoperative undernutrition was associated with increased SVA and decreased SFA at 2 years postoperatively in older patients undergoing surgery for ASD. These findings suggest that preoperative nutritional status may influence postoperative outcomes in this population, highlighting the importance of nutritional screening and intervention prior to surgery.

查看原文本刊更多论文

老年成人脊柱畸形患者术前营养不良与术后矢状垂直轴恶化相关。

背景：术前营养状况对接受成人脊柱畸形（ASD）手术的老年人术后临床结果的影响尚不清楚。本研究旨在探讨ASD手术患者术前营养状况与术后临床和放射预后之间的关系。方法：117例患者(平均年龄73.3±5.4岁；我们从多中心数据库中回顾性纳入了接受≥3个椎体融合术治疗ASD的77名女性。采用控制营养状态量表（CONUT）评估营养状况，该量表基于血清白蛋白、总淋巴细胞计数和总胆固醇水平，评分范围从0到10。根据患者的营养状况分为两组：营养不良（UN）组（CONUT评分≥2）和营养正常(N)组（CONUT评分0-1）。进行多变量回归分析以确定术后矢状位线恶化的独立预测因素。结果：N组67例，UN组50例。术后2年，UN组矢状垂直轴（SVA）明显大于N组（56.5±47.5 mm vs. 44.2±40.2 mm, P = 0.007），脊柱-股骨角（SFA）明显小于N组（194.4±19.3°vs. 202.6±19.2°，P = 0.029）。多因素分析显示术前营养不良是术后SVA恶化的独立预测因素。结论：在接受ASD手术的老年患者中，术前营养不良与术后2年SVA升高和SFA降低相关。这些发现表明，术前营养状况可能影响该人群的术后结果，强调了术前营养筛查和干预的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Orthopaedic Science 医学-整形外科

CiteScore

3.00

自引率

0.00%

发文量

290

审稿时长

90 days

期刊介绍： The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.