Bridges Tiffany, Meade Matthew, Brush Parker, Lee Yunsoo, Narayanan Rajkishen, McCurdy Michael A, Lambrechts Mark, Charlton Alex, Jenkins Eleanor, Juniewicz Robert, Destine Henson, Kaye Ian David, Kurd Mark, Canseco Jose, Hilibrand Alan, Vaccaro Alexander R, Schroeder Gregory, Kepler Christopher
Department of Orthopaedic Surgery, Jefferson Health in New Jersey, Stratford, NJ, USA.
Department of Orthopaedic Surgery, Rothman Orthopaedic Instituteat Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Global Spine J. 2025 Mar;15(2):1087-1093. doi: 10.1177/21925682231223461. Epub 2023 Dec 27.
Retrospective Cohort Study.
The objective of this study was to assess the impact of diet liberalization on short-term outcomes in patients undergoing anterior interbody lumbar fusion (ALIF).
A retrospective review was performed for patients undergoing ALIF at our tertiary care center institution from 2010 to 2022. Electronic medical records were reviewed for demographics, surgical characteristics, and 90-day postoperative outcomes.
We included 515 patients in this study with 102 patients receiving a full diet on the same day as their operation. All other patients had a delay of at least 1 day (average 1.6 days) until a full diet was provided. This group was found to have a higher rate of postoperative ileus (10.2% vs 2.9%) and urinary retention (16.0% vs 3.9%). The readmission rate and percent of patients presenting to the emergency department within 90 days postoperatively were similar. On multivariate regression analysis, same-day, full-diet patients had decreased odds of developing urinary retention (OR = .17) and a shorter length of hospital stay (Estimate: -.99). Immediate full diet had no impact on the development of ileus (OR: .33).
An immediate postoperative full diet following an anterior approach to the lumbar spine was not found to be associated with an increased risk of postoperative ileus in patients deemed appropriate for early diet liberalization. Moreover, an early full diet was found to reduce length of hospitalization and risk of postoperative urinary retention. Reconsideration of postoperative diet protocols may help optimize patient outcomes and recovery.
回顾性队列研究。
本研究的目的是评估饮食自由化对接受前路腰椎椎间融合术（ALIF）患者短期预后的影响。
对2010年至2022年在我们三级医疗中心机构接受ALIF的患者进行回顾性研究。查阅电子病历以获取人口统计学、手术特征和术后90天的预后情况。
本研究纳入了515例患者，其中102例患者在手术当天即恢复正常饮食。所有其他患者至少延迟1天（平均1.6天）才恢复正常饮食。发现该组患者术后肠梗阻发生率较高（10.2%对2.9%）和尿潴留发生率较高（16.0%对3.9%）。术后再入院率和术后90天内到急诊科就诊的患者百分比相似。多因素回归分析显示，手术当天即恢复正常饮食的患者发生尿潴留的几率降低（OR = 0.17），住院时间缩短（估计值：-0.99）。术后立即恢复正常饮食对肠梗阻的发生没有影响（OR：0.33）。
对于被认为适合早期饮食自由化的患者，腰椎前路手术后立即恢复正常饮食并未发现与术后肠梗阻风险增加相关。此外，早期恢复正常饮食可缩短住院时间并降低术后尿潴留风险。重新考虑术后饮食方案可能有助于优化患者预后和康复。
