Preoperative Immunonutrition in Patients Undergoing Spine Surgery

I.R.C.C.S Ospedale Galeazzi-Sant'Ambrogio

Status: Enrolling

Conditions: Arthrosis; Spine

Treatments: Dietary Supplement: Immuno-nutrition

Study type: Interventional

Funder types: Other

Identifiers

NCT05372289

L4144 (Other Grant/Funding Number)

ORTHOPACT (PI: M Briguglio)

Details and patient eligibility

About

A malnutritional status is known to be associated with altered immune function, reduced function, and worsen outcomes after orthopedic surgery. Medical and surgical complications are not uncommon in Orthopedics and infection rates are potentially life-threatening complications, with the highest morbidity, mortality, and healthcare costs. Most patients undergoing orthopedic surgery are elderly, malnourished, osteosarcopenic, sedentary, anemic, and suffer from low levels of vitamin D. A mono-nutrient supplement may be not sufficient for supporting the arthrodesis techniques, which are invasive open surgeries procedures with significant blood losses and the need of transfusions. In this therapeutic area, immuno-nutrition has been used in spine surgery, with the reduction of complications, revisions, and readmissions. In addition, prosthetic surgery outcomes have been observed to ameliorate by using this nutritional support. Therefore, preoperative oral immuno-nutrition therapy may be applied in older adults undergoing spine surgery to improve patients' outcomes and reduce complications.

This is a randomized, controlled, open-label, 2-arm non-parallel-group, single-center interventional study to assess the efficacy of an immuno-nutrition therapy vs. hospital standard of care in spine surgery to improve patients' outcomes. This is a single primary endpoint study. A total of 136 patients from IRCCS Orthopedic Institute Galeazzi in Italy will be recruited and assigned in a 1:1 ratio to the treatment arm.

Enrollment: 136 estimated patients

Sex: All

Ages: 60+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• male and female sex, of all ethnicities, aged over 60
• arthrodesis involving ≥ 6 vertebrae
• American Society of Anesthesiology (ASA) risk: 1, 2, or 3
• Absence of neurological or psychiatric disorders
• Signing of informed consent and consent to collaborate in all study procedures
• Patients who meet the clinical requirements to undergo their first spinal surgery

Exclusion criteria

• American Society of Anesthesiology (ASA) risk: 4
• No cervical arthrodesis
• Diagnosis of neurological or psychiatric disorders
• Revisions
• Therapy with other supplements at the time of the first visit 0
• Known allergy or adverse food reactions
• Chronic inflammatory or autoimmune diseases (e.g. rheumatoid arthritis)
• Gastrointestinal disorders
• Conditions that do not allow to undergo surgery

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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136 participants in 2 patient groups

Supplemented patients

Experimental group

Treatment:

Dietary Supplement: Immuno-nutrition

Standard of care

No Intervention group