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Enhanced Recovery After Surgery and Perioperative Optimization in Adult Cervical Deformity Surgery.
Tariq Said1, Mustafa Mahmood1, Bilal Butt1,2
1Department of Orthopaedic Surgery, Cleveland Clinic.
Clinical Spine Surgery
|October 30, 2025
Summary
Enhanced Recovery After Surgery (ERAS) protocols show promise in improving outcomes for adult cervical spinal deformity (ACSD) surgery. These protocols reduce complications and enhance patient recovery, supporting their wider implementation.
Area of Science:
- Spine Surgery
- Orthopedics
- Surgical Outcomes
Background:
- Adult cervical spinal deformity (ACSD) surgery is complex with high morbidity.
- Enhanced Recovery After Surgery (ERAS) protocols are underutilized in ACSD.
- ERAS aims to improve surgical outcomes via multimodal perioperative care.
Purpose of the Study:
- Synthesize current data on ERAS protocols and outcomes in ACSD.
- Focus on prehabilitation, opioid management, intraoperative strategies, SSI prevention, and mobilization.
- Review ERAS components, propose future research, and discuss clinical applications.
Main Methods:
- Review of 10 peer-reviewed studies (retrospective, prospective, systematic reviews).
- Analysis of methodological rigor and relevance to perioperative care in ACSD.
- Synthesis of findings on ERAS pathways for adult cervical spine deformity.
Main Results:
- ERAS protocols in ACSD are linked to reduced blood loss and operative time.
- ERAS is associated with decreased opioid use and complication rates.
- Improved functional outcomes, quality of life, and reduced surgical site infections (SSI) observed.
Conclusions:
- Early findings support formal development and institutional implementation of ERAS protocols for ACSD.
- Multicenter validation and protocol standardization are needed.
- ERAS offers a pathway to improve patient recovery and outcomes in complex spine surgery.
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