The Application of an Enhanced Recovery After Surgery to Spine Instrumentation

Özet

AIM: To evaluate the clinical and economic outcomes of the adoption of the enhanced recovery after spine surgery (ERSS) programin patients undergoing spine instrumentation.MATERIAL and METHODS: This study described the introduction of the ERSS program, and we compared 86 consecutive patientswho participated in ERSS with a retrospective cohort of 88 patients who underwent the same surgery before the implementationof this program.Groups were compared in terms of age, sex, body mass index (BMI), American Society of Anesthesiologist (ASA) physical scores,operative time, comorbidities, intraoperative blood loss, blood transfusion rate, first oral intake, time of first mobilization, length ofhospital stay, preoperative and postoperative pain scores using a numeric pain rating scale, 30-day readmission and complicationrates, and total cost.RESULTS: Groups were similar in terms of age, sex, BMI, ASA scores, and comorbidities. Intraoperative blood loss, blood transfusionrate, and length of hospital stay were lower in the ERSS group. First oral intake and first mobilization occurred earlier in the ERSSgroup. Postoperative pain scores were significantly lower in the ERSS group. Operative time, readmissions, or complications at 30days did not statistically differ between the two groups. The ERSS group was found to be significantly cost effective.CONCLUSION: ERSS is feasible, comprehensive, and cost effective for spine instrumentation with better perioperative outcomes.