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Transforming Outcomes of Spine Surgery-Exploring the Power of Enhanced Recovery After Surgery Protocol: A Systematic Review and Meta-Analyses of 15 198 Patients – Lumbar Spinal Stenosis

The article summarizes a systematic review and meta-analysis of studies comparing the outcomes and financial implications of spine surgeries performed with and without Enhanced Recovery After Surgery (ERAS) protocols. The analysis included 59 studies with a total of 15,198 patients. The results showed that patients treated with ERAS protocols had shorter operative times, shorter hospitalizations, fewer complications, reduced opioid use, and faster mobilization compared to non-ERAS patients. Additionally, spine surgeries using ERAS were associated with lower total costs, especially in the United States. The implementation of ERAS protocols was found to be safe and effective in reducing care costs and accelerating hospital discharge for patients undergoing spine surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised sugical centre in UK

Published article

CONCLUSION: The present meta-analysis indicates that current literature supports ERAS implementation as a means of reducing care costs and safely accelerating hospital discharge for patients undergoing spine surgery.

Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
Neurosurgery. 2024 Feb 15. doi: 10.1227/neu.0000000000002865. Online ahead of print.ABSTRACTBACKGROUND AND OBJECTIVES: Enhanced recovery after surgery (ERAS) protocols aim to optimize patient outcomes by reducing the surgical stress response, expediting recovery, and reducing care costs. We aimed to evaluate the impact of implementing ERAS protocols on the perioperative surgical outcomes and financial implications associated with,

Neurosurgery. 2024 Feb 15. doi: 10.1227/neu.0000000000002865. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Enhanced recovery after surgery (ERAS) protocols aim to optimize patient outcomes by reducing the surgical stress response, expediting recovery, and reducing care costs. We aimed to evaluate the impact of implementing ERAS protocols on the perioperative surgical outcomes and financial implications associated with spine surgeries.

METHODS: A systematic review and meta-analysis of peer-reviewed studies directly comparing outcome differences between spine surgeries performed with and without utilization of ERAS pathways was conducted along Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

RESULTS: Of 676 unique articles identified, 59 with 15 198 aggregate patients (7748 ERAS; 7450 non-ERAS) were included. ERAS-treated patients had shorter operative times (mean difference [MD]: 10.2 mins; P < .01), shorter hospitalizations (MD: 1.41 days, P < .01), fewer perioperative complications (relative risk [RR] = 0.64, P < .01), lower postoperative opioid use (MD of morphine equivalent dose: 164.36 mg; P < .01), and more rapid mobilization/time to first out-of-bed ambulation (MD: 0.92 days; P < .01). Spine surgeries employing ERAS were also associated with lower total costs (MD: $1140.26/patient; P < .01), especially in the United States (MD: $2869.11/patient, P < .01) and lower postoperative visual analog pain scores (MD = 0.56, P < .01), without any change in odds of 30-day readmission (RR: 0.80, P = .13) or reoperation (RR: 0.88, P = .60). Subanalyses based on the region of spine showed significantly lower length of stay in both cervical and lumbar surgeries implementing ERAS. Type of procedure showed a significantly lesser time-to-initiate mobilization in fusion surgeries using ERAS protocols compared with decompression.

CONCLUSION: The present meta-analysis indicates that current literature supports ERAS implementation as a means of reducing care costs and safely accelerating hospital discharge for patients undergoing spine surgery.

PMID:38358272 | DOI:10.1227/neu.0000000000002865

The London Spine Unit : most specialised sugical centre in UK

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Transforming Outcomes of Spine Surgery-Exploring the Power of Enhanced Recovery After Surgery Protocol: A Systematic Review and Meta-Analyses of 15 198 Patients

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Neurosurgery. 2024 Feb 15. doi: 10.1227/neu.0000000000002865. Online ahead of print.ABSTRACTBACKGROUND AND OBJECTIVES: Enhanced recovery after surgery (ERAS) protocols aim to optimize patient outcomes by reducing the surgical stress response, expediting recovery, and reducing care costs. We aimed to evaluate the impact of implementing ERAS protocols on the perioperative surgical outcomes and financial implications associated with
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