Facilitating Earlier Discharge for Patients Undergoing Spine Surgery

As the population ages and the incidence of spine surgeries increases, better solutions are needed for the challenges of adequate pain control and lengthy hospital stays, which often result from difficulty with controlling pain, managing complications, or coordinating post-hospitalization care services. Thus, there is an inherent need for ways to improve pain and time to discharge. Minimally invasive techniques aim to minimize tissue disruption and can decrease pain and accelerate recovery. However, these techniques are not indicated for all spine patients, and not all spine surgeons are adequately trained in such techniques, thus limiting generalizability. In contrast, Enhanced Recovery After Surgery (ERAS) has recently been adopted within spine surgery as an alternative management strategy to optimize patient outcomes. Enhanced recovery principles mitigate the surgical stress response through a series of evidence-based, perioperative interventions that have demonstrated success with reducing postoperative pain and complications, increasing ambulation, and shortening length of stay. While still in its infancy within spine surgery, there is ample evidence for the successful implementation of ERAS programs for numerous spine procedures. However, further randomized trials will likely be needed to support the continued application of ERAS within spine surgery.