Enhanced Recovery After Surgery Protocols and Spinal Deformity

Area of Science:

• Orthopedics
• Neurosurgery
• Anesthesiology

Background:

• Adult spinal deformity (ASD) presents complex surgical challenges.
• Optimizing patient care requires a multidisciplinary approach across all surgical phases.

Purpose of the Study:

• To review key considerations for adult spinal deformity surgery.
• To integrate enhanced recovery after surgery (ERAS) protocols.

Main Methods:

• Literature review of preoperative, intraoperative, and postoperative management strategies.
• Discussion of specific interventions like imaging, glycemic control, bone health, antibiotics, analgesia, and mobilization.

Main Results:

• Preoperative optimization includes imaging, HbA1c management, osteoporosis treatment, and prehabilitation.
• Intraoperative care involves antibiotics, liposomal bupivacaine, and Foley catheter use.
• Postoperative management focuses on pain control, antiemetics, DVT prophylaxis, and early mobilization.

Conclusions:

• Implementing ERAS protocols can enhance outcomes for complex spinal surgery patients.
• This review provides a framework for optimizing care in adult spinal deformity.
• Further research is needed to refine ERAS protocols for this population.