Updated: Aug 21, 2019
Any form of surgical procedure causes the body physiological stress (1), the extent to which depends on the severity of the surgery.
Orthopaedic surgery can also have a big impact on your nutritional status (2).
This article looks at ways to optimise your nutritional status prior to spinal fusion surgery.
Healthy and Balanced Diet
In general, there is no specific diet that needs to be followed prior to spinal fusion surgery other than a well-balanced and healthy diet.
We should all be aiming to eat more fruits and vegetables (3), wholegrains, and oily fish, keeping the Government EatWell Guide in mind (see figure 1) (4). In the UK, it is recommended that we consume two portions of fish a week (5), with at least one portion (140g) from oily fish (i.e. salmon, herrings). Choose lean meats and low-fat dairy as well as heart-healthy fats such as olive oil and rapeseed oil. Limit the amount of saturated fat, alcohol and caffeine consumed in your diet.
Most people in the UK consume above the recommended daily amount of protein (6), however if you follow a vegan or vegetarian diet, make sure you are consuming adequate amounts of protein from plant-based sources i.e. lentils, chickpeas, peanuts, tofu, edamame beans.
It’s also important to make sure you are drinking enough water in the lead up to your surgery to avoid dehydration, as this can lead to post-operative complications (7). A good way to check your hydration status is to check the colour of your urine. Aim for a pale straw (see figure 2) yellow colour and if it is dark, drink more fluids!
There are no specific clinical guidelines on vitamin and mineral supplementation prior to spinal fusion surgery.
The UK government recommends that everyone (excluding babies receiving more than 500ml infant formula per day) should take a daily 10 microgram vitamin D supplement, particularly during Autumn and winter. This is due to the reduced exposure to sunlight - the main source of vitamin D in the UK (8).
Vitamin D is an important component in musculoskeletal development and deficiency is thought to have widespread consequences for bone healing (9).
It is important that you inform your surgeon of any other supplements or herbal remedies which you are taking prior to your operation, as these may interact with certain medications (10).
Optimising Your Nutritional Status:
Studies have shown that being malnourished prior to orthopaedic surgery is associated with a significantly higher risk of post-operative complications such as surgical site infections (11).
A person is classified as malnourished if they meet a set of criteria which includes (12):
A low BMI (<20 kg/m2)
Unintentional weight loss (5-10% of their usual body weight) over the past 3-6 months
Being acutely unwell with little or no nutritional intake for 5 or more days
Nutritional screening is recommended in NICE guidelines for all inpatient hospital admissions in the UK. You will probably have your height and weight measured during your pre-op assessment and at regular intervals after your operation.
It is important to consult a healthcare professional if you are concerned about your weight as they will be able to conduct nutritional risk screening and can refer you to a dietitian if necessary.
Prior to surgery, you will be required to fast (usually overnight) to reduce your risk of complications during the general anaesthetic (15).
Most hospitals have their own fasting policies, and your hospital will inform you of the fasting guidelines prior to your operation. If you have diabetes, make sure you discuss this with your medical team prior to fasting.
Nutrition can play an important role in helping to facilitate your recovery post spinal fusion surgery.
For most people, eating a nutritious and balanced diet and maintaining a healthy body weight is sufficient prior to surgery.
However, if you have any concerns about your nutritional intake or your weight prior to spinal surgery, speak to a healthcare professional. If appropriate, they may be able to refer you to a Registered Dietitian.
This blog post is a shorter summary of an article written for The Scoliosis Association UK on pre- and post- surgical nutrition. This article was peer-reviewed by The Lancet.
Written by Harriet Smith, RD. This article is intended for general educational purposes only. Please refer to our disclaimer for more information.