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Enhanced Recovery After Surgery Trends in Adult Spine Surgery: A Systematic Review.
Yixuan Tong1, Laviel Fernandez2, John A Bendo2
1New York University Grossman School of Medicine, New York, New York.
International Journal of Spine Surgery
|September 28, 2020
Summary
Enhanced Recovery After Surgery (ERAS) protocols show promise in spine surgery by reducing hospital stays and opioid use. However, best practices and outcomes vary significantly across different spinal procedures.
Area of Science:
- Orthopedic Surgery
- Evidence-Based Medicine
- Patient Recovery
Background:
- Enhanced Recovery After Surgery (ERAS) is a multimodal approach to optimize postsurgical recovery.
- ERAS protocols are increasingly adopted in orthopedic spine surgery, but consensus on best practices is lacking.
Purpose of the Study:
- To systematically review trends in spine ERAS protocols.
- To analyze the associated outcomes of ERAS implementation in adult spine surgery.
Main Methods:
- Systematic literature search of PubMed and reference lists for studies on spine ERAS protocols (published through December 2019).
- Inclusion of clinical studies on adult spine procedures implementing ERAS.
- Manual data extraction on study design, interventions, and outcomes.
Main Results:
- Twenty-two studies met inclusion criteria, revealing common ERAS elements: preoperative education, modified nutrition, multimodal analgesia, minimally invasive surgery, and early mobilization.
- ERAS implementation correlated with reduced length of stay, cost, and opioid consumption.
- Significant variability exists in ERAS protocols and reported outcomes across studies.
Conclusions:
- ERAS protocols offer potential cost-effectiveness and reduced opioid consumption in spinal procedures, particularly through multimodal analgesia.
- The benefits of ERAS in spine surgery are procedure-dependent.
- This review provides an assessment of ERAS protocol implementation in adult spine surgery.
