Perioperative Nutrition Management in Patients Undergoing Open Posterior Lumbar Surgery

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.