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Perioperative Nutrition Management in Patients Undergoing Open Posterior Lumbar Surgery
Sponsor: First Affiliated Hospital of Kunming Medical University
Summary
Patients undergoing open posterior lumbar fusion surgery often experience postoperative gastrointestinal problems, such as bloating, constipation, and delayed passage of gas and stool, and may be at nutritional risk. These problems may hinder recovery and prolong hospital stay. This study enrolled 90 patients undergoing open posterior lumbar fusion surgery at the Department of Orthopedics, First Affiliated Hospital of Kunming Medical University. Participants were randomly assigned in a 1:1:1 ratio to three groups: a control group receiving routine perioperative care with standard dietary guidance; experimental group A receiving perioperative oral nutritional supplements (ONS) together with preoperative and postoperative carbohydrate loading; and experimental group B receiving the same ONS and carbohydrate loading plus a probiotic preparation. The primary outcome was the length of postoperative hospital stay. Other assessments included time to first postoperative flatus, time to first postoperative bowel movement, cumulative postoperative drainage volume, drainage duration, and time to first postoperative mobilization out of bed. Surgical wound healing, postoperative infections, and overall postoperative complications were assessed during hospitalization and at the outpatient follow-up visit 1 month after surgery. Additional assessments included anthropometric measurements, laboratory tests, and scores evaluating pain, function, nutritional risk, nutritional status, dietary intake, and gastrointestinal function. Anthropometric measurements were obtained at hospital admission and at the pre-discharge assessment. The Visual Analog Scale (VAS) for overall pain, Japanese Orthopaedic Association (JOA) low back pain score, Nutritional Risk Screening 2002 (NRS-2002), full Mini Nutritional Assessment (MNA), Simple Diet Self-Assessment Tool (SDSAT), and simplified gastrointestinal function score were assessed at hospital admission, on postoperative day 3, at the pre-discharge assessment, and at 1 month after surgery. Laboratory tests were performed before surgery and on postoperative days 1, 3, and 6. The aim was to evaluate the clinical value of perioperative nutrition management in spinal surgery and explore whether adding probiotics provided further benefit. The study was intended to inform the development of a practical perioperative nutrition management plan to support recovery, shorten hospital stay, and reduce postoperative complications.
Official title: Perioperative Nutrition Management in Patients Undergoing Open Posterior Lumbar Surgery: A Comparative Study of No Intervention, Nutrition Support, and Combined Probiotic Therapy
Key Details
Gender
All
Age Range
Any - Any
Study Type
INTERVENTIONAL
Enrollment
90
Start Date
2025-05-22
Completion Date
2026-02-20
Last Updated
2026-11-03
Healthy Volunteers
No
Interventions
Oral nutritional supplements (ONS)
Perioperative optimized oral nutritional supplements (whole-nutrient formula plus whey protein; diabetes-specific formula for patients with diabetes), taken as between-meal snacks from 2 days before surgery to 5 days after surgery, to reach an energy target of about 30 kcal/kg/day and protein intake of 1.5-2.0 g/kg/day.
Carbohydrate loading (OCL)
Preoperative and postoperative oral carbohydrate loading. A 12.5% carbohydrate drink is given as 400 ml at 10 hours and 200 ml at 2 hours before surgery, and 200 ml after waking from anesthesia, followed by a liquid and semi-liquid diet as tolerated.
'Probiotics (Bifidobacterium and Lactobacillus triple live capsules)'
Bifidobacterium and Lactobacillus triple live capsules (a live microbial preparation), 2 g orally three times daily, from 2 days before surgery to 5 days after surgery.
Locations (1)
First Affiliated Hospital of Kunming Medical University
Kunming, Yunnan, China