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Malnutrition in Spine Surgery: Assessment, Management, and the Role of Sarcopenia
Joseph E Nassar1, Ashley Knebel1, Manjot Singh1
1Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI.
Study Design:
This is an evidence-based narrative review article.
Objective:
We aim to evaluate the impact of malnutrition on perioperative outcomes in spine surgery, particularly its association with sarcopenia and frailty, and emphasize the importance of standardized screening and management protocols.
Background:
Malnutrition is a significant yet often overlooked condition that affects spine surgery outcomes, contributing to higher morbidity, prolonged hospital stays, and increased health care costs. Despite its prevalence, there is a lack of consistent protocols for its identification and management in surgical practice.
Methods:
This review synthesizes existing literature on malnutrition in spine surgery, focusing on evidence-based methods for preoperative nutritional assessment, including laboratory markers, validated screening tools, and innovative imaging techniques such as full-body standing radiographs for muscle mass evaluation.
Results:
We explore nutritional optimization strategies, including targeted protein supplementation and multimodal dietary interventions, which have been shown to improve surgical recovery and minimize complications. The review also highlights the relationship between malnutrition, sarcopenia, and frailty, and their collective impact on perioperative outcomes.
Conclusions:
Given the growing recognition of perioperative nutritional status as a modifiable risk factor, implementing standardized protocols for malnutrition screening and management is essential to improving patient outcomes following spine surgery.