Enhanced recovery after elective spinal surgery: an Australian pilot study

Area of Science:

• Neurosurgery
• Surgical Outcomes
• Evidence-Based Medicine

Background:

• Enhanced Recovery After Surgery (ERAS) principles aim to minimize surgical stress and improve outcomes.
• ERAS adoption in spinal surgery, particularly in Australia, is nascent.
• This study introduces an evidence-based ERAS pathway for simple spine surgery in Australia.

Purpose of the Study:

• To describe the initial experience with an ERAS pathway for elective simple spine surgery.
• To evaluate the feasibility and outcomes of implementing ERAS in Australian spinal surgery.
• To assess patient outcomes, length of stay, and complication rates.

Main Methods:

• A prospective cohort analysis of 52 patients undergoing elective spinal decompression surgery (lumbar and cervical) under ERAS principles.
• Data collected on length of stay, patient-reported pain and disability, and complications (readmissions, re-operations).
• Analysis included predictors of same-day discharge failure.

Main Results:

• 83.7% of patients (43/52) were successfully discharged on the same day of surgery.
• Patient-reported outcomes improved at 6 weeks and 6 months, indicating durable results.
• Complication rates were comparable to literature, with no 30-day readmissions or 6-month re-operations.

Conclusions:

• Implementing ERAS protocols for simple spinal decompression surgery is feasible and effective.
• ERAS pathways lead to improved patient outcomes and reduced hospital length of stay.
• Patient social factors, such as non-English speaking background and living alone, were predictors of same-day discharge failure.