FPDY078
Free Paper (Deformity)
Correlation between nutritional status, assessed by MNA-SF, and clinical outcomes in patients undergo spinal deformity surgery
Kotaro Oda, Tetsuro Ohba, Nobuki Tanaka, Hayato Takei, Kai Mizukami, Go Goto
Hirotaka Haro University of Yamanashi
Summary of Background Data: Malnutrition is common among older patients undergoing ASD surgery and is linked to postoperative infection, delayed recovery, and increased morbidity. Laboratory-based nutritional markers have limitations related to inflammation and slow response. The MNA-SF is a simple, noninvasive screening tool; however, its clinical value and postoperative course in ASD surgery remain unclear.
Objective: To evaluate perioperative changes in nutritional status using the Mini Nutritional Assessment–Short Form (MNA-SF) and analyze its association with clinical and mechanical complications after adult spinal deformity (ASD) surgery.
Methods: 100 patients over 60 years old who underwent ASD correction and completed MNA-SF assessments preoperatively and at 1 year postoperatively were included. Radiographic parameters, bone mineral density, and biochemical indices were collected. Associations between preoperative MNA-SF, postoperative MNA-SF, change in MNA-SF (ΔMNA- SF), and postoperative complications—including early and late surgical site infection (SSI), rod breakage, and proximal junctional failure (PJF)—were analyzed.
Results: The mean MNA-SF score improved significantly from 11.1 preoperatively to 11.9 at 1 year (p = 0.0035). Preoperative MNA-SF correlated positively with YAM (r = 0.338) and HbA1c (r = 0.344) but not with albumin or vitamin D. Neither preoperative nor postoperative MNA-SF scores were associated with postoperative complications. A smaller ΔMNA-SF was linked to late SSI (p = 0.011), whereas a greater ΔMNA-SF was associated with rod breakage (p = 0.018). No relationship was found between ΔMNA-SF and early SSI or PJF.
Conclusion: Nutritional status assessed using the MNA-SF significantly improved 1 year after ASD surgery. Although baseline and postoperative MNA- SF scores did not predict complications, postoperative nutritional improvement was associated with reduced late infection risk and increased rod fracture incidence. The MNA-SF may serve as a simple perioperative screening tool for patients with ASD.