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Enhanced recovery after elective spinal surgery: an Australian pilot study – Lumbar Spinal Stenosis

The article discusses the implementation of enhanced recovery after surgery (ERAS) principles in spinal surgery, specifically for simple spinal decompression procedures in Australia. The study outlines the development of an evidence-based ERAS protocol and analyzes the outcomes of patients undergoing elective spinal decompression surgery under these principles. The results showed that a majority of patients were successfully discharged on the same day as their surgery, with improved patient reported outcomes at 6 weeks and 6 months post-surgery. Complication rates were similar to reported rates for simple decompression procedures, with no readmissions or re-operations within 6 months. The study concludes that implementing ERAS protocols for spinal surgery is feasible and leads to improved patient outcomes and reduced hospital length of stay. Patient social factors were found to be predictive of lack of compliance with same-day discharge

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSIONS: Implementation of ERAS protocols for simple spinal decompression surgeries is feasible and produces durable improved patient outcomes while reducing LOS in hospitals. Patient social factors can be predictive of lack of compliance.

Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
J Spine Surg. 2024 Mar 20;10(1):30-39. doi: 10.21037/jss-23-115. Epub 2024 Jan 16. ABSTRACT BACKGROUND: The principles of enhanced recovery after surgery (ERAS) aim to reduce the physiological stress of surgery which in turn improve clinical and health economic outcomes. There is ample evidence in literature supporting ERAS methodologies in other surgical specialties, but its adoption,

J Spine Surg. 2024 Mar 20;10(1):30-39. doi: 10.21037/jss-23-115. Epub 2024 Jan 16.

ABSTRACT

BACKGROUND: The principles of enhanced recovery after surgery (ERAS) aim to reduce the physiological stress of surgery which in turn improve clinical and health economic outcomes. There is ample evidence in literature supporting ERAS methodologies in other surgical specialties, but its adoption in spinal surgery, especially in Australia remains in infancy. The aim of this project is to describe the early experience with an evidence-based ERAS pathway for simple spine surgery, a first of its kind in Australia.

METHODS: An ERAS protocol was designed using an evidenced-based review of the literature. The authors then conducted a prospective cohort analysis looking at outcome of patients undergoing elective spinal (lumbar and cervical) decompression surgery under ERAS principles by a single surgeon on the Westmead Hospital Campus between March 2021 to May 2023. Primary outcomes were patient length of stay (LOS), patient reported pain and disability scores and complications (including readmissions within 30 days and re-operation within 6 months). Secondary outcomes included predictors of failure for same-day discharge.

RESULTS: A total of 52 patients underwent spinal decompression surgeries under the ERAS protocol. Overall 43 out of 52 patients (83.7%) were successfully discharged on the same day as their surgery. Patient reported outcomes were improved at 6 weeks and 6 months confirming durability of intervention. The rates of complications were similar to literature reported rates for simple lumbar or cervical decompression procedures and there were no readmissions within 30 days or re-operations within 6 months of surgery. Being of non-English speaking background [odds ratio (OR) =6.08, P=0.04] and from home alone (OR =10.25, P=0.03) were predictors of failure of same day discharge in this small cohort.

CONCLUSIONS: Implementation of ERAS protocols for simple spinal decompression surgeries is feasible and produces durable improved patient outcomes while reducing LOS in hospitals. Patient social factors can be predictive of lack of compliance.

PMID:38567012 | PMC:PMC10982920 | DOI:10.21037/jss-23-115

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Enhanced recovery after elective spinal surgery: an Australian pilot study

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J Spine Surg. 2024 Mar 20;10(1):30-39. doi: 10.21037/jss-23-115. Epub 2024 Jan 16. ABSTRACT BACKGROUND: The principles of enhanced recovery after surgery (ERAS) aim to reduce the physiological stress of surgery which in turn improve clinical and health economic outcomes. There is ample evidence in literature supporting ERAS methodologies in other surgical specialties, but its adoption

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