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Enhanced Recovery After Lumbar Fusion Surgery: An International Survey on Current Practice
Hein H R Jonkman1,2, Floris R van Tol2, Tim M Govers3
1Department of Medical Imaging, Radboud University Medical Center, Nijmegen, Netherlands.
Global Spine Journal
|March 12, 2026
Summary
Spine surgeons identified multimodal opioid-sparing analgesia, early mobilization, and preoperative education as key for Enhanced Recovery After Surgery (ERAS) in lumbar fusion. Addressing barriers like unclear protocols and staff shortages is crucial for successful ERAS implementation.
Area of Science:
- Orthopedic Surgery
- Surgical Innovation
- Patient Recovery
Background:
- Enhanced Recovery After Surgery (ERAS) programs aim to optimize patient outcomes and reduce recovery times.
- Implementing ERAS in degenerative lumbar fusion presents unique challenges and requires understanding surgeon perspectives.
Purpose of the Study:
- To evaluate spine surgeons' views on the significance of various ERAS components for lumbar fusion.
- To identify barriers hindering the adoption of ERAS programs in this surgical context.
Main Methods:
- A cross-sectional, international web-based survey was distributed to AOSpine members in May 2024.
- The survey assessed perceptions of eight ERAS components, focusing on impact and areas for improvement, alongside implementation barriers.
Main Results:
- Multimodal opioid-sparing analgesia, early mobilization, and preoperative education were deemed most impactful and having the greatest room for improvement.
- Key implementation barriers included lack of clear protocols, staff shortages, and coordination difficulties.
Conclusions:
- Focusing on multimodal analgesia, early mobilization, and preoperative education can significantly enhance ERAS effectiveness in lumbar fusion.
- Targeted interventions addressing identified barriers are essential for successful ERAS program implementation.
