Objective:

Enhanced Recovery After Surgery (ERAS) is a multimodal, evidence-based approach to perioperative care that aims to reduce physiological and psychological stress, improve the quality of rehabilitation and speed up the recovery of patients. Our study aims to investigate the benefits of perioperative use of ERAS for short-segment posterior lumbar interbody fusion (PLIF).

Methods:

We selected two 1-year periods: the first from before the establishment of the multidisciplinary ERAS team in January 2017 (pre-ERAS year 2016) and the second period when ERAS was applied widely in our hospital (ERAS year 2019). Data were collected from the electronic medical records of patients who had undergone short-level PLIF during these 2 periods. The primary outcomes were postoperative complications, length of hospital stay (LOS) and off-bed time.

Results:

A total of 207 patients were included; 95 patients in the pre-ERAS group were compared with 112 patients in the ERAS group. There was no significant difference between the two groups in baseline demographic. Patients in the ERAS group had significantly shorter LOS, bed-off time and earlier drainage tube and catheter removal time. The rate of postoperative complications differed significantly between the pre-ERAS and ERAS groups. Patients in the ERAS group had significantly less intraoperative blood loss, financial cost and opioid consumption than patients in the pre-ERAS group. The VAS and ODI scores, similar at baseline, were significantly lower in the ERAS group at postoperative day 3 (POD 3).

Conclusions:

The benefits of our ERAS protocol for patients undergoing short-level posterior lumbar fusion are evident in terms of reduced hospital stay and time to get out of bed, reduced incidence of postoperative complications, intraoperative blood loss, opioid use and hospital costs, and improved early postoperative pain and dysfunction.