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Enhanced Recovery After Surgery Protocol for Oblique Lumbar Interbody Fusion

  • Original Article
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Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Background

Enhanced recovery after surgery (ERAS) attempts to decrease the surgical stress response to minimize postoperative complications and improve functional rehabilitation after major surgery, but it has not been widely utilized in spinal surgery. The study reported the development and implementation of an ERAS pathway for patients with lumbar spondylolisthesis undergoing oblique lumbar interbody fusion (OLIF).

Methods

Seventy-six patients underwent OLIF surgery from January 2018 to December 2019 were enrolled. Thirty-seven patients were included in pre-ERAS group and 39 patients were included in ERAS group. Major outcomes that were collected included demographics, comorbidities, blood loss, operative time, length of hospital stay (LOS), cost, time to walk, blood transfusion, complications, Visual analogue scale (VAS) scores, Oswestry Disability Index (ODI) and factors affecting LOS were also recorded. The ERAS pathway and compliance with pathway elements were also recorded.

Results

After ERAS implementation, the blood loss, LOS, the financial costs, and the time to walk were significantly lower in the ERAS group compared to the pre-ERAS group (all P < 0.05). There was no significant difference in operative time, complications, and blood transfusion between both groups. VAS and ODI between the two groups showed a significant difference during postoperative 3 days and postoperative 1 month (both P < 0.05). The preoperative time to walk was significant factors for hospital stay at the final follow-up.

Conclusion

Institution of an ERAS protocol for OLIF surgery appears to accelerate functional recovery, reduce length of stay and financial costs.

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Abbreviations

OLIF:

Oblique lumbar interbody fusion

ERAS:

Enhanced recovery after surgery

VAS:

Visual analogue scale

ODI:

Oswestry Disability Index

COPD:

Chronic obstructive pulmonary disease

CCD:

Chronic cardiovascular disease

BMI:

Body mass index

LOS:

Length of stay

USD:

US Dollar

TXA:

Tranexamic acid

VTE:

Vein thromboembolism

PONV:

Postoperative nausea and vomiting

POD:

Postoperative day

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Acknowledgements

Thanks to all the patients involved in this study from the first affiliated hospital of Soochow University. The study was approved by the Medical Ethics Committees of The First Affiliated Hospital of Soochow University.

Funding

There were no external funding sources for this study.

Author information

Author notes

  1. Xiaofeng Shao, Renjie Li, Lichen Zhang have contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, Jiangsu, 215006, People’s Republic of China

    Xiaofeng Shao, Renjie Li, Lichen Zhang & Weimin Jiang

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  1. Xiaofeng Shao
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  2. Renjie Li
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  3. Lichen Zhang
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Contributions

Shao XF assisted with care of the patient and wrote majority of the manuscript. Li RJ and Zhang LC helped with literature review and writing assistance. Jiang WM performed the surgery and approved the manuscript.

Corresponding author

Correspondence to Weimin Jiang.

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Conflict of interests

The authors declare that they have no competing interests.

Ethical Approval

The study was approved by the Medical Ethics Committees of The First Affiliated Hospital of Soochow University.

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Shao, X., Li, R., Zhang, L. et al. Enhanced Recovery After Surgery Protocol for Oblique Lumbar Interbody Fusion. JOIO 56, 1073–1082 (2022). https://doi.org/10.1007/s43465-022-00641-4

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  • DOI: https://doi.org/10.1007/s43465-022-00641-4

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