Propuesta de abordaje nutricional basado en evidencia para el manejo integral de un paciente con sarcopenia y discopatía con parestesia: análisis retrospectivo de un caso clínico.

Abstract

Introduction: Secondary sarcopenia is a musculoskeletal disorder associated with inflammation, prolonged immobilization, and major surgical procedures characterized by a progressive loss of muscle mass, strength, and function. Its presence hinders functional recovery, increases the risk of complications, and may coexist with obesity, leading to sarcopenic obesity. In this context, nutritional therapy plays a fundamental role in mitigating muscle mass loss, promoting muscle protein synthesis, and optimizing the rehabilitation process. Objective: To develop individualized nutritional strategy based on available scientific evidence for an adult female patient with secondary sarcopenia following mayor surgery, aimed at promoting the recovery of muscle mass function, improving nutritional status, and contributing to rehabilitation. Case presentation: A clinical case of a 26 year old female patient with lumbar disc disease and parestesia who underwent a discectomy with disc replacement and subsequently developed secondary sarcopenia due to prolonged immobility, sarcopenic obesity, and insulin resistance is presented. Nutritional assessment was conducted following using the Nutrition Care Process, integrating medical history, anthropometric, biochemical, dietary, and functional assessment, together with the GLIM, EWGSOP2, and ESPEN-EASO criteria. Impaired muscle function, vitamin D deficiency, chronic constipation, and inadequate nutritional intake were identified. .Proposed nutritional intervention: An individualized strategy was proposed to meet energy and protein requirements, correct nutritional deficiencies, and promote recovery through nutritional therapy, suplplementation, nutrition education, and physical rehabilitation. Conclusions: Comprehensive nutritional assessment and the Nutritional Care Process made it easier to identify key factors affecting the patient’s nutritional and functional estatus, which facilitated the development of a comprehensive treatment plan tailored to her clinical needs. Clinical evidence suggests that an individualized nutritional strategy, integrated with physical rehabilitation multidisciplinary care, can help preserve muscle mass, optimize functional recovery, and improve the prognosis of patients with secondary sarcopenia following major surgery.