ERAS and Spine Surgery
Treatment of spine disease in the elderly : cutting edge techniques and technologies
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Enhanced Recovery After Surgery (ERAS) protocols are multidisciplinary approaches to perioperative care, which aim to optimize surgical recovery by incorporating evidence-based approaches in the preoperative, intraoperative, and postoperative periods. As such, the goal of these strategies is to minimize stressors from various physiological and psychological sources. There is a compelling case for the implementation of ERAS into the routine management of spinal surgery, as many of these procedures are associated with long operative durations, considerable homeostatic stress, and significant postoperative pain which can lead to prolonged recovery, delayed mobilization, and increased opioid use. Elderly patients are a particularly vulnerable patient population in elective spinal surgery, as they tend to have more medical comorbidities and are also more sensitive to opioids. The purpose of this chapter is to summarize the components of ERAS protocols as they relate to spine surgery, and highlight advances in perioperative management such as the role of multimodal analgesia and minimally invasive techniques. A comprehensive literature review of published ERAS protocols and outcomes is provided.
Degenerative, Elderly, Enhanced recovery after surgery, ERAS, Fusion, Instrumentation, Multimodal, Pain, Spine
Staudt, M.D., Zhou, X., Wijesekera, O., Miller, J.P., Sweet, J.A. ERAS and spine surgery. In: Fu, Km.G., Wang, M.Y., Virk, M.S., Dimar Ii, J.R., Mummaneni, P.V. (eds) Treatment of spine disease in the elderly. Springer, Cham; 2023 doi: 10.1007/978-3-031-12612-3_6