Trial Into the Effects of Repeated Neck Retractions in Normal Subjects

STUDY DESIGN: A prospective analysis of nutritional status after surgery in 57 spinal reconstructive surgery patients. OBJECTIVES: 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. SUMMARY OF BACKGROUND DATA: 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.