Perioperative Nutritional Optimization in Complex Pediatric Hip and Spine Surgery: A Systematic Review

While isolated laboratory values are inconsistent predictors, underweight status and weight loss are more reliable indicators of risk. ERAS protocols incorporating nutritional strategies may improve outcomes, although more pediatric-focused data are needed. The lack of standardized malnutrition definitions across studies limits comparability. Future research should establish uniform nutritional screening practices and evaluate specific interventions in high-risk pediatric orthopaedic populations. Despite limitations in study heterogeneity and small sample sizes, this review supports integrating structured perioperative nutrition into care pathways.