ERAS in Spine Surgery

Enhanced recovery after surgery (ERAS) programs afford the opportunity to remedy several challenges within spine surgery. Increasing surgical demand, rising costs, and variability in outcomes favor the need for development of ERAS recommendations in spine surgery. Therefore, official guideline recommendations will likely be published in the coming year. These guidelines were completed following a comprehensive literature search for each of 16 enhanced recovery topics. The majority of interventions remain similar to ERAS recommendations in other subspecialties, consisting primarily of preoperative education and health optimization strategies, multimodal medication protocols during the intraoperative and postoperative periods, and early mobilization with rehabilitation following surgery. Prior to the advent of published ERAS recommendations in spine surgery, several programs have already successfully implemented elements of enhanced recovery for a variety of spine procedures. The success of these programs provides stronger evidence for the utility of ERAS within spine surgery and demonstrates that full implementation of an ERAS program will likely improve recovery for these patients. International and multidisciplinary collaboration will serve to guide ERAS implementation into the future of spine surgery.