{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:06:30Z","timestamp":1793318790279,"version":"4.5.0"},"reference-count":72,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,4]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Enhanced Recovery After Surgery (ERAS) proposes a multimodal, evidence-based approach to perioperative care. Thanks to the improvement in care protocols and the fluidity of the patient pathway, the first goal of ERAS is the improvement of surgical outcomes and patient experience, with a final impact on a reduction in the hospital length of stay (LOS). The implementation of ERAS in spinal surgery is in the early stages. The authors report on their initial experience in applying an ERAS program to several degenerative spinal fusion procedures.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The authors selected two 2-year periods: the first from before any implementation of ERAS principles (pre-ERAS years 2012\u20132013) and the second corresponding to a period when the paradigm was applied widely (post-ERAS years 2016\u20132017). Patient groups in these periods were retrospectively compared according to three degenerative conditions requiring fusion: anterior cervical discectomy and fusion (ACDF), anterior lumbar interbody fusion (ALIF), and posterior lumbar fusion. Data were collected on patient demographics, operative and perioperative data, LOSs, 90-day readmissions, and morbidity. ERAS-trained nurses were involved to support patients at each pre-, intra-, and postoperative step with the help of a mobile application (app). A satisfaction survey was included in the app.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The pre-ERAS group included 1563 patients (159 ALIF, 749 ACDF, and 655 posterior fusion), and the post-ERAS group included 1920 patients (202 ALIF, 612 ACDF, and 1106 posterior fusion). The mean LOS was significantly shorter in the post-ERAS group than in the pre-ERAS group for all three conditions. It was reduced from 6.06 \u00b1 1.1 to 3.33 \u00b1 0.8 days for the ALIF group (p < 0.001), from 3.08 \u00b1 0.9 to 1.3 \u00b1 0.7 days for the ACDF group (p < 0.001), and from 6.7 \u00b1 4.8 to 4.8 \u00b1 2.3 days for posterior fusion cases (p < 0.001). There was no significant difference in overall complications between the two periods for the ALIF (11.9% pre-ERAS vs 11.4% post-ERAS, p = 0.86) and ACDF (6.0% vs 8.2%, p = 0.12) cases, but they decreased significantly for lumbar fusions (14.8% vs 10.9%, p = 0.02). Regarding satisfaction with overall care among 808 available responses, 699 patients (86.5%) were satisfied or very satisfied, and regarding appreciation of the mobile e-health app in the perceived optimization of care management, 665 patients (82.3%) were satisfied or very satisfied.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The introduction of the ERAS approach at the authors\u2019 institution for spinal fusion for three studied conditions resulted in a significant decrease in LOS without causing increased postoperative complications. Patient satisfaction with overall management, upstream organization of hospitalization, and the use of e-health was high. According to the study results, which are consistent with those in other studies, the whole concept of ERAS (primarily reducing complications and pain, and then reducing LOS) seems applicable to spinal surgery.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2019.1.focus18669","type":"journal-article","created":{"date-parts":[[2019,4,9]],"date-time":"2019-04-09T16:06:55Z","timestamp":1554826015000},"page":"E6","source":"Crossref","is-referenced-by-count":124,"title":["Benefits of Enhanced Recovery After Surgery for fusion in degenerative spine surgery: impact on outcome, length of stay, and patient satisfaction"],"prefix":"10.3171","volume":"46","author":[{"given":"Bertrand","family":"Debono","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, CAPIO-Clinique des C\u00e8dres, Cornebarrieu, France; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco V.","family":"Corniola","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine Unit, Geneva University Hospitals, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Pietton","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, CAPIO-Clinique des C\u00e8dres, Cornebarrieu, France; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Sabatier","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, CAPIO-Clinique des C\u00e8dres, Cornebarrieu, France; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Hamel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, CAPIO-Clinique des C\u00e8dres, Cornebarrieu, France; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Tessitore","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine Unit, Geneva University Hospitals, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/j.clineuro.2017.12.003","article-title":"Pre-optimization of spinal surgery patients: development of a neurosurgical enhanced recovery after surgery (ERAS) protocol","volume":"164","author":"Ali ZS","year":"2018","unstructured":"Ali ZS, Ma TS, Ozturk AK, Malhotra NR, Schuster JM, Marcotte PJ, : Pre-optimization of spinal surgery patients: development of a neurosurgical enhanced recovery after surgery (ERAS) protocol. Clin Neurol Neurosurg 164:142\u2013153, 201810.1016\/j.clineuro.2017.12.00329232645"},{"issue":"6","key":"b2","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E1","DOI":"10.3171\/2014.3.FOCUS1447","article-title":"Variations in cost calculations in spine surgery cost-effectiveness research","volume":"36","author":"Alvin MD","year":"2014","unstructured":"Alvin MD, Miller JA, Lubelski D, Rosenbaum BP, Abdullah KG, Whitmore RG, : Variations in cost calculations in spine surgery cost-effectiveness research. Neurosurg Focus 36(6):E1, 201410.3171\/2014.3.FOCUS144724881633"},{"issue":"42","key":"b3","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1097\/BRS.0000000000001703","article-title":"Reduction of inpatient hospital length of stay in lumbar fusion patients with implementation of an evidence-based clinical care pathway","author":"Bradywood A","year":"2017","unstructured":"Bradywood A, Farrokhi F, Williams B, Kowalczyk M, Blackmore CC: Reduction of inpatient hospital length of stay in lumbar fusion patients with implementation of an evidence-based clinical care pathway. Spine (Phila Pa 1976) 42:169\u2013176, 20172721393910.1097\/BRS.0000000000001703"},{"key":"b4","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1093\/bja\/aeu265","article-title":"Anaesthesiology and perioperative medicine around the world: different names, same goals","volume":"114","author":"Cannesson M","year":"2015","unstructured":"Cannesson M, Ani F, Mythen MM, Kain Z: Anaesthesiology and perioperative medicine around the world: different names, same goals. Br J Anaesth 114:8\u20139, 20152514535510.1093\/bja\/aeu265"},{"key":"b5","series-title":"J Clin Anesth","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1016\/0952-8180(95)00130-A","article-title":"A post-anesthetic discharge scoring system for home readiness after ambulatory surgery","volume":"7","author":"Chung F","year":"1995","unstructured":"Chung F, Chan VW, Ong D: A post-anesthetic discharge scoring system for home readiness after ambulatory surgery. J Clin Anesth 7:500\u2013506, 1995853446810.1016\/0952-8180(95)00130-A"},{"key":"b6","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"3536","DOI":"10.1007\/s00586-016-4680-4","article-title":"Postoperative monitoring with a mobile application after ambulatory lumbar discectomy: an effective tool for spine surgeons","volume":"25","author":"Debono B","year":"2016","unstructured":"Debono B, Bousquet P, Sabatier P, Plas JY, Lescure JP, Hamel O: Postoperative monitoring with a mobile application after ambulatory lumbar discectomy: an effective tool for spine surgeons. Eur Spine J 25:3536\u20133542, 201610.1007\/s00586-016-4680-427349754"},{"issue":"43","key":"b7","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1097\/BRS.0000000000002272","article-title":"Indication variability in degenerative lumbar spine surgery: a four-nation survey","author":"Debono B","year":"2018","unstructured":"Debono B, Lonjon G, Galovich LA, Kerever S, Guiot B, Eicker SO, : Indication variability in degenerative lumbar spine surgery: a four-nation survey. Spine (Phila Pa 1976) 43:185\u2013192, 20182860448610.1097\/BRS.0000000000002272"},{"key":"b8","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1016\/j.wneu.2017.07.065","article-title":"Outpatient lumbar microdiscectomy in France: from an economic imperative to a clinical standard\u2014an observational study of 201 cases","volume":"106","author":"Debono B","year":"2017","unstructured":"Debono B, Sabatier P, Garnault V, Hamel O, Bousquet P, Lescure JP, : Outpatient lumbar microdiscectomy in France: from an economic imperative to a clinical standard\u2014an observational study of 201 cases. World Neurosurg 106:891\u2013897, 20172873512010.1016\/j.wneu.2017.07.065"},{"key":"b9","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1016\/j.spinee.2014.11.004","article-title":"Fusion surgery for lumbar degenerative disc disease: still more questions than answers","volume":"15","author":"Deyo RA","year":"2015","unstructured":"Deyo RA: Fusion surgery for lumbar degenerative disc disease: still more questions than answers. Spine J 15:272\u2013274, 20152559827910.1016\/j.spinee.2014.11.004"},{"key":"b10","series-title":"Orthopade","doi-asserted-by":"publisher","first-page":"1062","DOI":"10.1007\/s00132-014-3040-5","article-title":"[Pre- and postoperative fast-track treatment concepts in spinal surgery: patient information and patient cooperation.]","volume":"43","author":"Fleege C","unstructured":"Fleege C, Arabmotlagh M, Almajali A, Rauschmann M: [Pre- and postoperative fast-track treatment concepts in spinal surgery: patient information and patient cooperation.] Orthopade 43:1062\u20131064, 1066\u20131069, 2014 (Ger)10.1007\/s00132-014-3040-525387654"},{"key":"b11","series-title":"Anesthesiology","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1097\/ALN.0b013e31828866b3","article-title":"Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures","volume":"118","author":"Gerbershagen HJ","year":"2013","unstructured":"Gerbershagen HJ, Aduckathil S, van Wijck AJM, Peelen LM, Kalkman CJ, Meissner W: Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology 118:934\u2013944, 20132339223310.1097\/ALN.0b013e31828866b3"},{"key":"b12","series-title":"World J Urol","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1007\/s00345-006-0139-2","article-title":"Fast-track surgery in laparoscopic radical prostatectomy: basic principles","volume":"25","author":"Gralla O","year":"2007","unstructured":"Gralla O, Haas F, Knoll N, Hadzidiakos D, Tullmann M, Romer A, : Fast-track surgery in laparoscopic radical prostatectomy: basic principles. World J Urol 25:185\u2013191, 20071717156310.1007\/s00345-006-0139-2"},{"key":"b13","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"588","DOI":"10.3171\/2018.4.SPINE171317","article-title":"Implementation of an Enhanced Recovery After Spine Surgery program at a large cancer center: a preliminary analysis","volume":"29","author":"Grasu RM","year":"2018","unstructured":"Grasu RM, Cata JP, Dang AQ, Tatsui CE, Rhines LD, Hagan KB, : Implementation of an Enhanced Recovery After Spine Surgery program at a large cancer center: a preliminary analysis. J Neurosurg Spine 29:588\u2013598, 201810.3171\/2018.4.SPINE171317"},{"key":"b14","series-title":"JMIR Mhealth Uhealth","doi-asserted-by":"publisher","first-page":"e113","DOI":"10.2196\/mhealth.6023","article-title":"Evaluating patient usability of an image-based mobile health platform for postoperative wound monitoring","volume":"4","author":"Gunter R","year":"2016","unstructured":"Gunter R, Fernandes-Taylor S, Mahnke A, Awoyinka L, Schroeder C, Wiseman J, : Evaluating patient usability of an image-based mobile health platform for postoperative wound monitoring. JMIR Mhealth Uhealth 4:e113, 201610.2196\/mhealth.602327683059"},{"key":"b15","series-title":"Ann R Coll Surg Engl","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1308\/003588414X13824511649571","article-title":"A systematic review of patient reported outcomes and patient experience in enhanced recovery after orthopaedic surgery","volume":"96","author":"Jones EL","year":"2014","unstructured":"Jones EL, Wainwright TW, Foster JD, Smith JRA, Middleton RG, Francis NK: A systematic review of patient reported outcomes and patient experience in enhanced recovery after orthopaedic surgery. Ann R Coll Surg Engl 96:89\u201394, 201410.1308\/003588414X1382451164957124780662"},{"key":"b16","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1093\/bja\/78.5.606","article-title":"Multimodal approach to control postoperative pathophysiology and rehabilitation","volume":"78","author":"Kehlet H","year":"1997","unstructured":"Kehlet H: Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth 78:606\u2013617, 199710.1093\/bja\/78.5.6069175983"},{"key":"b17","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1093\/bja\/aev098","article-title":"Perioperative medicine\u2014the second round will need a change of tactics","volume":"115","author":"Kehlet H","year":"2015","unstructured":"Kehlet H, Delaney CP, Hill AG: Perioperative medicine\u2014the second round will need a change of tactics. Br J Anaesth 115:13\u201314, 201510.1093\/bja\/aev098"},{"key":"b18","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"1921","DOI":"10.1016\/S0140-6736(03)14966-5","article-title":"Anaesthesia, surgery, and challenges in postoperative recovery","volume":"362","author":"Kehlet H","year":"2003","unstructured":"Kehlet H, Dahl JB: Anaesthesia, surgery, and challenges in postoperative recovery. Lancet 362:1921\u20131928, 200310.1016\/S0140-6736(03)14966-514667752"},{"issue":"Suppl 1","key":"b19","series-title":"Knee","doi-asserted-by":"publisher","first-page":"S29","DOI":"10.1016\/S0968-0160(13)70006-1","article-title":"Fast-track knee arthroplasty\u2014status and future challenges","volume":"20","author":"Kehlet H","year":"2013","unstructured":"Kehlet H, Thienpont E: Fast-track knee arthroplasty\u2014status and future challenges. Knee 20 (Suppl 1):S29\u2013S33, 201310.1016\/S0968-0160(13)70006-1"},{"key":"b20","series-title":"Ann Surg","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1097\/SLA.0b013e31817f2c1a","article-title":"Evidence-based surgical care and the evolution of fast-track surgery","volume":"248","author":"Kehlet H","year":"2008","unstructured":"Kehlet H, Wilmore DW: Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg 248:189\u2013198, 200810.1097\/SLA.0b013e31817f2c1a18650627"},{"key":"b21","series-title":"JAMA Surg","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1001\/jamasurg.2016.4952","article-title":"Enhanced Recovery After Surgery: a review","volume":"152","author":"Ljungqvist O","year":"2017","unstructured":"Ljungqvist O, Scott M, Fearon KC: Enhanced Recovery After Surgery: a review. JAMA Surg 152:292\u2013298, 20172809730510.1001\/jamasurg.2016.4952"},{"issue":"22 Suppl 1","key":"b22","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"S65","DOI":"10.1097\/BRS.0000000000000571","article-title":"Is minimal access spine surgery more cost-effective than conventional spine surgery?","volume":"39","author":"Lubelski D","year":"2014","unstructured":"Lubelski D, Mihalovich KE, Skelly AC, Fehlings MG, Harrop JS, Mummaneni PV, : Is minimal access spine surgery more cost-effective than conventional spine surgery? Spine (Phila Pa 1976) 39 (22 Suppl 1):S65\u2013S74, 201410.1097\/BRS.0000000000000571"},{"key":"b23","series-title":"Int J Surg","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.ijsu.2015.04.071","article-title":"Evidence-based surgery: the obstacles and solutions","volume":"18","author":"Meshikhes AWN","year":"2015","unstructured":"Meshikhes AWN: Evidence-based surgery: the obstacles and solutions. Int J Surg 18:159\u2013162, 20152593441610.1016\/j.ijsu.2015.04.071"},{"key":"b24","series-title":"Eur J Vasc Endovasc Surg","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1016\/j.ejvs.2007.04.018","article-title":"Fast track open aortic surgery: reduced post operative stay with a goal directed pathway","volume":"34","author":"Murphy MA","year":"2007","unstructured":"Murphy MA, Richards T, Atkinson C, Perkins J, Hands LJ: Fast track open aortic surgery: reduced post operative stay with a goal directed pathway. Eur J Vasc Endovasc Surg 34:274\u2013278, 200710.1016\/j.ejvs.2007.04.01817587613"},{"issue":"31","key":"b25","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1503","DOI":"10.1097\/01.brs.0000220652.39970.c2","article-title":"Intraoperative adverse events and related postoperative complications in spine surgery: implications for enhancing patient safety founded on evidence-based protocols","author":"Rampersaud YR","year":"2006","unstructured":"Rampersaud YR, Moro ERP, Neary MA, White K, Lewis SJ, Massicotte EM, : Intraoperative adverse events and related postoperative complications in spine surgery: implications for enhancing patient safety founded on evidence-based protocols. Spine (Phila Pa 1976) 31:1503\u20131510, 20061674146210.1097\/01.brs.0000220652.39970.c2"},{"key":"b26","series-title":"Neurosurgery","first-page":"740","article-title":"National rates, causes, risk factors, and outcomes associated with 30-day and 90-day readmissions following degenerative posterior cervical spine surgery utilizing the Nationwide Readmissions Database","volume":"81","author":"Rumalla K","year":"2017","unstructured":"Rumalla K, Smith KA, Arnold PM: National rates, causes, risk factors, and outcomes associated with 30-day and 90-day readmissions following degenerative posterior cervical spine surgery utilizing the Nationwide Readmissions Database. Neurosurgery 81:740\u2013751, 201728368483"},{"key":"b27","series-title":"JMIR Mhealth Uhealth","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.2196\/mhealth.3929","article-title":"Using a mobile app for monitoring post-operative quality of recovery of patients at home: a feasibility study","volume":"3","author":"Semple JL","year":"2015","unstructured":"Semple JL, Sharpe S, Murnaghan ML, Theodoropoulos J, Metcalfe KA: Using a mobile app for monitoring post-operative quality of recovery of patients at home: a feasibility study. JMIR Mhealth Uhealth 3:e18, 201510.2196\/mhealth.3929"},{"key":"b28","series-title":"Spine (Phila Pa 1976)","article-title":"Design and implementation of an Enhanced Recovery After Surgery (ERAS) program for minimally invasive lumbar decompression spine surgery: initial experience","author":"Soffin EM","unstructured":"Soffin EM, Vaishnav AS, Wetmore D, Barber L, Hill P, Gang CH, : Design and implementation of an Enhanced Recovery After Surgery (ERAS) program for minimally invasive lumbar decompression spine surgery: initial experience. Spine (Phila Pa 1976) [epub ahead of print], 201830325887"},{"key":"b29","series-title":"Acta Orthop","doi-asserted-by":"publisher","first-page":"702","DOI":"10.3109\/17453674.2015.1063910","article-title":"High patient satisfaction in 445 patients who underwent fast-track hip or knee replacement","volume":"86","author":"Specht K","year":"2015","unstructured":"Specht K, Kjaersgaard-Andersen P, Kehlet H, Wedderkopp N, Pedersen BD: High patient satisfaction in 445 patients who underwent fast-track hip or knee replacement. Acta Orthop 86:702\u2013707, 20152610912410.3109\/17453674.2015.1063910"},{"key":"b30","series-title":"Can J Anaesth","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1007\/s12630-014-0272-0","article-title":"Health economics in Enhanced Recovery After Surgery programs","volume":"62","author":"Stowers MDJ","year":"2015","unstructured":"Stowers MDJ, Lemanu DP, Hill AG: Health economics in Enhanced Recovery After Surgery programs. Can J Anaesth 62:219\u2013230, 201510.1007\/s12630-014-0272-025391739"},{"key":"b31","series-title":"JMIR Res Protoc","doi-asserted-by":"publisher","first-page":"e245","DOI":"10.2196\/resprot.6580","article-title":"Substitution of usual perioperative care by ehealth to enhance postoperative recovery in patients undergoing general surgical or gynecological procedures: study protocol of a randomized controlled trial","volume":"5","author":"van der Meij E","year":"2016","unstructured":"van der Meij E, Huirne JA, Bouwsma EV, van Dongen JM, Terwee CB, van de Ven PM, : Substitution of usual perioperative care by ehealth to enhance postoperative recovery in patients undergoing general surgical or gynecological procedures: study protocol of a randomized controlled trial. JMIR Res Protoc 5:e245, 201610.2196\/resprot.6580"},{"key":"b32","series-title":"J Neurosurg Sci","first-page":"245","article-title":"A perspective on the use of an enhanced recovery program in open, non-instrumented day surgery for degenerative lumbar and cervical spinal conditions","volume":"62","author":"Venkata HK","year":"2018","unstructured":"Venkata HK, van Dellen JR: A perspective on the use of an enhanced recovery program in open, non-instrumented day surgery for degenerative lumbar and cervical spinal conditions. J Neurosurg Sci 62:245\u2013254, 201827078237"},{"issue":"6S","key":"b33","series-title":"J Visc Surg","doi-asserted-by":"publisher","first-page":"S33","DOI":"10.1016\/j.jviscsurg.2016.10.001","article-title":"How to introduce a program of Enhanced Recovery after Surgery? The experience of the CAPIO group","volume":"153","author":"Verrier JF","year":"2016","unstructured":"Verrier JF, Paget C, Perlier F, Demesmay F: How to introduce a program of Enhanced Recovery after Surgery? The experience of the CAPIO group. J Visc Surg 153 (6S):S33\u2013S39, 201610.1016\/j.jviscsurg.2016.10.001"},{"key":"b34","series-title":"Best Pract Res Clin Anaesthesiol","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.bpa.2015.11.001","article-title":"Enhanced recovery after surgery (ERAS) and its applicability for major spine surgery","volume":"30","author":"Wainwright TW","year":"2016","unstructured":"Wainwright TW, Immins T, Middleton RG: Enhanced recovery after surgery (ERAS) and its applicability for major spine surgery. Best Pract Res Clin Anaesthesiol 30:91\u2013102, 20162703660610.1016\/j.bpa.2015.11.001"},{"key":"b35","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1093\/neuros\/nyx400","article-title":"Reduced acute care costs with the ERAS\u00ae minimally invasive transforaminal lumbar interbody fusion compared with conventional minimally invasive transforaminal lumbar interbody fusion","volume":"83","author":"Wang MY","year":"2018","unstructured":"Wang MY, Chang HK, Grossman J: Reduced acute care costs with the ERAS\u00ae minimally invasive transforaminal lumbar interbody fusion compared with conventional minimally invasive transforaminal lumbar interbody fusion. Neurosurgery 83:827\u2013834, 201810.1093\/neuros\/nyx40028945854"},{"key":"b36","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"411","DOI":"10.3171\/2016.9.SPINE16375","article-title":"Development of an Enhanced Recovery After Surgery (ERAS) approach for lumbar spinal fusion","volume":"26","author":"Wang MY","year":"2017","unstructured":"Wang MY, Chang PY, Grossman J: Development of an Enhanced Recovery After Surgery (ERAS) approach for lumbar spinal fusion. J Neurosurg Spine 26:411\u2013418, 201710.3171\/2016.9.SPINE16375"},{"key":"b1","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/j.clineuro.2017.12.003","article-title":"Pre-optimization of spinal surgery patients: development of a neurosurgical enhanced recovery after surgery (ERAS) protocol","volume":"164","author":"Ali ZS","year":"2018","unstructured":"Ali ZS, Ma TS, Ozturk AK, Malhotra NR, Schuster JM, Marcotte PJ, : Pre-optimization of spinal surgery patients: development of a neurosurgical enhanced recovery after surgery (ERAS) protocol. Clin Neurol Neurosurg 164:142\u2013153, 201810.1016\/j.clineuro.2017.12.00329232645"},{"issue":"6","key":"b2","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E1","DOI":"10.3171\/2014.3.FOCUS1447","article-title":"Variations in cost calculations in spine surgery cost-effectiveness research","volume":"36","author":"Alvin MD","year":"2014","unstructured":"Alvin MD, Miller JA, Lubelski D, Rosenbaum BP, Abdullah KG, Whitmore RG, : Variations in cost calculations in spine surgery cost-effectiveness research. Neurosurg Focus 36(6):E1, 201410.3171\/2014.3.FOCUS144724881633"},{"issue":"42","key":"b3","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1097\/BRS.0000000000001703","article-title":"Reduction of inpatient hospital length of stay in lumbar fusion patients with implementation of an evidence-based clinical care pathway","author":"Bradywood A","year":"2017","unstructured":"Bradywood A, Farrokhi F, Williams B, Kowalczyk M, Blackmore CC: Reduction of inpatient hospital length of stay in lumbar fusion patients with implementation of an evidence-based clinical care pathway. Spine (Phila Pa 1976) 42:169\u2013176, 20172721393910.1097\/BRS.0000000000001703"},{"key":"b4","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1093\/bja\/aeu265","article-title":"Anaesthesiology and perioperative medicine around the world: different names, same goals","volume":"114","author":"Cannesson M","year":"2015","unstructured":"Cannesson M, Ani F, Mythen MM, Kain Z: Anaesthesiology and perioperative medicine around the world: different names, same goals. Br J Anaesth 114:8\u20139, 20152514535510.1093\/bja\/aeu265"},{"key":"b5","series-title":"J Clin Anesth","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1016\/0952-8180(95)00130-A","article-title":"A post-anesthetic discharge scoring system for home readiness after ambulatory surgery","volume":"7","author":"Chung F","year":"1995","unstructured":"Chung F, Chan VW, Ong D: A post-anesthetic discharge scoring system for home readiness after ambulatory surgery. J Clin Anesth 7:500\u2013506, 1995853446810.1016\/0952-8180(95)00130-A"},{"key":"b6","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"3536","DOI":"10.1007\/s00586-016-4680-4","article-title":"Postoperative monitoring with a mobile application after ambulatory lumbar discectomy: an effective tool for spine surgeons","volume":"25","author":"Debono B","year":"2016","unstructured":"Debono B, Bousquet P, Sabatier P, Plas JY, Lescure JP, Hamel O: Postoperative monitoring with a mobile application after ambulatory lumbar discectomy: an effective tool for spine surgeons. Eur Spine J 25:3536\u20133542, 201610.1007\/s00586-016-4680-427349754"},{"issue":"43","key":"b7","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1097\/BRS.0000000000002272","article-title":"Indication variability in degenerative lumbar spine surgery: a four-nation survey","author":"Debono B","year":"2018","unstructured":"Debono B, Lonjon G, Galovich LA, Kerever S, Guiot B, Eicker SO, : Indication variability in degenerative lumbar spine surgery: a four-nation survey. Spine (Phila Pa 1976) 43:185\u2013192, 20182860448610.1097\/BRS.0000000000002272"},{"key":"b8","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1016\/j.wneu.2017.07.065","article-title":"Outpatient lumbar microdiscectomy in France: from an economic imperative to a clinical standard\u2014an observational study of 201 cases","volume":"106","author":"Debono B","year":"2017","unstructured":"Debono B, Sabatier P, Garnault V, Hamel O, Bousquet P, Lescure JP, : Outpatient lumbar microdiscectomy in France: from an economic imperative to a clinical standard\u2014an observational study of 201 cases. World Neurosurg 106:891\u2013897, 20172873512010.1016\/j.wneu.2017.07.065"},{"key":"b9","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1016\/j.spinee.2014.11.004","article-title":"Fusion surgery for lumbar degenerative disc disease: still more questions than answers","volume":"15","author":"Deyo RA","year":"2015","unstructured":"Deyo RA: Fusion surgery for lumbar degenerative disc disease: still more questions than answers. Spine J 15:272\u2013274, 20152559827910.1016\/j.spinee.2014.11.004"},{"key":"b10","series-title":"Orthopade","doi-asserted-by":"publisher","first-page":"1062","DOI":"10.1007\/s00132-014-3040-5","article-title":"[Pre- and postoperative fast-track treatment concepts in spinal surgery: patient information and patient cooperation.]","volume":"43","author":"Fleege C","unstructured":"Fleege C, Arabmotlagh M, Almajali A, Rauschmann M: [Pre- and postoperative fast-track treatment concepts in spinal surgery: patient information and patient cooperation.] Orthopade 43:1062\u20131064, 1066\u20131069, 2014 (Ger)10.1007\/s00132-014-3040-525387654"},{"key":"b11","series-title":"Anesthesiology","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1097\/ALN.0b013e31828866b3","article-title":"Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures","volume":"118","author":"Gerbershagen HJ","year":"2013","unstructured":"Gerbershagen HJ, Aduckathil S, van Wijck AJM, Peelen LM, Kalkman CJ, Meissner W: Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology 118:934\u2013944, 20132339223310.1097\/ALN.0b013e31828866b3"},{"key":"b12","series-title":"World J Urol","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1007\/s00345-006-0139-2","article-title":"Fast-track surgery in laparoscopic radical prostatectomy: basic principles","volume":"25","author":"Gralla O","year":"2007","unstructured":"Gralla O, Haas F, Knoll N, Hadzidiakos D, Tullmann M, Romer A, : Fast-track surgery in laparoscopic radical prostatectomy: basic principles. World J Urol 25:185\u2013191, 20071717156310.1007\/s00345-006-0139-2"},{"key":"b13","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"588","DOI":"10.3171\/2018.4.SPINE171317","article-title":"Implementation of an Enhanced Recovery After Spine Surgery program at a large cancer center: a preliminary analysis","volume":"29","author":"Grasu RM","year":"2018","unstructured":"Grasu RM, Cata JP, Dang AQ, Tatsui CE, Rhines LD, Hagan KB, : Implementation of an Enhanced Recovery After Spine Surgery program at a large cancer center: a preliminary analysis. J Neurosurg Spine 29:588\u2013598, 201810.3171\/2018.4.SPINE171317"},{"key":"b14","series-title":"JMIR Mhealth Uhealth","doi-asserted-by":"publisher","first-page":"e113","DOI":"10.2196\/mhealth.6023","article-title":"Evaluating patient usability of an image-based mobile health platform for postoperative wound monitoring","volume":"4","author":"Gunter R","year":"2016","unstructured":"Gunter R, Fernandes-Taylor S, Mahnke A, Awoyinka L, Schroeder C, Wiseman J, : Evaluating patient usability of an image-based mobile health platform for postoperative wound monitoring. JMIR Mhealth Uhealth 4:e113, 201610.2196\/mhealth.602327683059"},{"key":"b15","series-title":"Ann R Coll Surg Engl","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1308\/003588414X13824511649571","article-title":"A systematic review of patient reported outcomes and patient experience in enhanced recovery after orthopaedic surgery","volume":"96","author":"Jones EL","year":"2014","unstructured":"Jones EL, Wainwright TW, Foster JD, Smith JRA, Middleton RG, Francis NK: A systematic review of patient reported outcomes and patient experience in enhanced recovery after orthopaedic surgery. Ann R Coll Surg Engl 96:89\u201394, 201410.1308\/003588414X1382451164957124780662"},{"key":"b16","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1093\/bja\/78.5.606","article-title":"Multimodal approach to control postoperative pathophysiology and rehabilitation","volume":"78","author":"Kehlet H","year":"1997","unstructured":"Kehlet H: Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth 78:606\u2013617, 199710.1093\/bja\/78.5.6069175983"},{"key":"b17","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1093\/bja\/aev098","article-title":"Perioperative medicine\u2014the second round will need a change of tactics","volume":"115","author":"Kehlet H","year":"2015","unstructured":"Kehlet H, Delaney CP, Hill AG: Perioperative medicine\u2014the second round will need a change of tactics. Br J Anaesth 115:13\u201314, 201510.1093\/bja\/aev098"},{"key":"b18","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"1921","DOI":"10.1016\/S0140-6736(03)14966-5","article-title":"Anaesthesia, surgery, and challenges in postoperative recovery","volume":"362","author":"Kehlet H","year":"2003","unstructured":"Kehlet H, Dahl JB: Anaesthesia, surgery, and challenges in postoperative recovery. Lancet 362:1921\u20131928, 200310.1016\/S0140-6736(03)14966-514667752"},{"issue":"Suppl 1","key":"b19","series-title":"Knee","doi-asserted-by":"publisher","first-page":"S29","DOI":"10.1016\/S0968-0160(13)70006-1","article-title":"Fast-track knee arthroplasty\u2014status and future challenges","volume":"20","author":"Kehlet H","year":"2013","unstructured":"Kehlet H, Thienpont E: Fast-track knee arthroplasty\u2014status and future challenges. Knee 20 (Suppl 1):S29\u2013S33, 201310.1016\/S0968-0160(13)70006-1"},{"key":"b20","series-title":"Ann Surg","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1097\/SLA.0b013e31817f2c1a","article-title":"Evidence-based surgical care and the evolution of fast-track surgery","volume":"248","author":"Kehlet H","year":"2008","unstructured":"Kehlet H, Wilmore DW: Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg 248:189\u2013198, 200810.1097\/SLA.0b013e31817f2c1a18650627"},{"key":"b21","series-title":"JAMA Surg","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1001\/jamasurg.2016.4952","article-title":"Enhanced Recovery After Surgery: a review","volume":"152","author":"Ljungqvist O","year":"2017","unstructured":"Ljungqvist O, Scott M, Fearon KC: Enhanced Recovery After Surgery: a review. JAMA Surg 152:292\u2013298, 20172809730510.1001\/jamasurg.2016.4952"},{"issue":"22 Suppl 1","key":"b22","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"S65","DOI":"10.1097\/BRS.0000000000000571","article-title":"Is minimal access spine surgery more cost-effective than conventional spine surgery?","volume":"39","author":"Lubelski D","year":"2014","unstructured":"Lubelski D, Mihalovich KE, Skelly AC, Fehlings MG, Harrop JS, Mummaneni PV, : Is minimal access spine surgery more cost-effective than conventional spine surgery? Spine (Phila Pa 1976) 39 (22 Suppl 1):S65\u2013S74, 201410.1097\/BRS.0000000000000571"},{"key":"b23","series-title":"Int J Surg","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.ijsu.2015.04.071","article-title":"Evidence-based surgery: the obstacles and solutions","volume":"18","author":"Meshikhes AWN","year":"2015","unstructured":"Meshikhes AWN: Evidence-based surgery: the obstacles and solutions. Int J Surg 18:159\u2013162, 20152593441610.1016\/j.ijsu.2015.04.071"},{"key":"b24","series-title":"Eur J Vasc Endovasc Surg","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1016\/j.ejvs.2007.04.018","article-title":"Fast track open aortic surgery: reduced post operative stay with a goal directed pathway","volume":"34","author":"Murphy MA","year":"2007","unstructured":"Murphy MA, Richards T, Atkinson C, Perkins J, Hands LJ: Fast track open aortic surgery: reduced post operative stay with a goal directed pathway. Eur J Vasc Endovasc Surg 34:274\u2013278, 200710.1016\/j.ejvs.2007.04.01817587613"},{"issue":"31","key":"b25","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1503","DOI":"10.1097\/01.brs.0000220652.39970.c2","article-title":"Intraoperative adverse events and related postoperative complications in spine surgery: implications for enhancing patient safety founded on evidence-based protocols","author":"Rampersaud YR","year":"2006","unstructured":"Rampersaud YR, Moro ERP, Neary MA, White K, Lewis SJ, Massicotte EM, : Intraoperative adverse events and related postoperative complications in spine surgery: implications for enhancing patient safety founded on evidence-based protocols. Spine (Phila Pa 1976) 31:1503\u20131510, 20061674146210.1097\/01.brs.0000220652.39970.c2"},{"key":"b26","series-title":"Neurosurgery","first-page":"740","article-title":"National rates, causes, risk factors, and outcomes associated with 30-day and 90-day readmissions following degenerative posterior cervical spine surgery utilizing the Nationwide Readmissions Database","volume":"81","author":"Rumalla K","year":"2017","unstructured":"Rumalla K, Smith KA, Arnold PM: National rates, causes, risk factors, and outcomes associated with 30-day and 90-day readmissions following degenerative posterior cervical spine surgery utilizing the Nationwide Readmissions Database. Neurosurgery 81:740\u2013751, 201728368483"},{"key":"b27","series-title":"JMIR Mhealth Uhealth","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.2196\/mhealth.3929","article-title":"Using a mobile app for monitoring post-operative quality of recovery of patients at home: a feasibility study","volume":"3","author":"Semple JL","year":"2015","unstructured":"Semple JL, Sharpe S, Murnaghan ML, Theodoropoulos J, Metcalfe KA: Using a mobile app for monitoring post-operative quality of recovery of patients at home: a feasibility study. JMIR Mhealth Uhealth 3:e18, 201510.2196\/mhealth.3929"},{"key":"b28","series-title":"Spine (Phila Pa 1976)","article-title":"Design and implementation of an Enhanced Recovery After Surgery (ERAS) program for minimally invasive lumbar decompression spine surgery: initial experience","author":"Soffin EM","unstructured":"Soffin EM, Vaishnav AS, Wetmore D, Barber L, Hill P, Gang CH, : Design and implementation of an Enhanced Recovery After Surgery (ERAS) program for minimally invasive lumbar decompression spine surgery: initial experience. Spine (Phila Pa 1976) [epub ahead of print], 201830325887"},{"key":"b29","series-title":"Acta Orthop","doi-asserted-by":"publisher","first-page":"702","DOI":"10.3109\/17453674.2015.1063910","article-title":"High patient satisfaction in 445 patients who underwent fast-track hip or knee replacement","volume":"86","author":"Specht K","year":"2015","unstructured":"Specht K, Kjaersgaard-Andersen P, Kehlet H, Wedderkopp N, Pedersen BD: High patient satisfaction in 445 patients who underwent fast-track hip or knee replacement. Acta Orthop 86:702\u2013707, 20152610912410.3109\/17453674.2015.1063910"},{"key":"b30","series-title":"Can J Anaesth","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1007\/s12630-014-0272-0","article-title":"Health economics in Enhanced Recovery After Surgery programs","volume":"62","author":"Stowers MDJ","year":"2015","unstructured":"Stowers MDJ, Lemanu DP, Hill AG: Health economics in Enhanced Recovery After Surgery programs. Can J Anaesth 62:219\u2013230, 201510.1007\/s12630-014-0272-025391739"},{"key":"b31","series-title":"JMIR Res Protoc","doi-asserted-by":"publisher","first-page":"e245","DOI":"10.2196\/resprot.6580","article-title":"Substitution of usual perioperative care by ehealth to enhance postoperative recovery in patients undergoing general surgical or gynecological procedures: study protocol of a randomized controlled trial","volume":"5","author":"van der Meij E","year":"2016","unstructured":"van der Meij E, Huirne JA, Bouwsma EV, van Dongen JM, Terwee CB, van de Ven PM, : Substitution of usual perioperative care by ehealth to enhance postoperative recovery in patients undergoing general surgical or gynecological procedures: study protocol of a randomized controlled trial. JMIR Res Protoc 5:e245, 201610.2196\/resprot.6580"},{"key":"b32","series-title":"J Neurosurg Sci","first-page":"245","article-title":"A perspective on the use of an enhanced recovery program in open, non-instrumented day surgery for degenerative lumbar and cervical spinal conditions","volume":"62","author":"Venkata HK","year":"2018","unstructured":"Venkata HK, van Dellen JR: A perspective on the use of an enhanced recovery program in open, non-instrumented day surgery for degenerative lumbar and cervical spinal conditions. J Neurosurg Sci 62:245\u2013254, 201827078237"},{"issue":"6S","key":"b33","series-title":"J Visc Surg","doi-asserted-by":"publisher","first-page":"S33","DOI":"10.1016\/j.jviscsurg.2016.10.001","article-title":"How to introduce a program of Enhanced Recovery after Surgery? The experience of the CAPIO group","volume":"153","author":"Verrier JF","year":"2016","unstructured":"Verrier JF, Paget C, Perlier F, Demesmay F: How to introduce a program of Enhanced Recovery after Surgery? The experience of the CAPIO group. J Visc Surg 153 (6S):S33\u2013S39, 201610.1016\/j.jviscsurg.2016.10.001"},{"key":"b34","series-title":"Best Pract Res Clin Anaesthesiol","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.bpa.2015.11.001","article-title":"Enhanced recovery after surgery (ERAS) and its applicability for major spine surgery","volume":"30","author":"Wainwright TW","year":"2016","unstructured":"Wainwright TW, Immins T, Middleton RG: Enhanced recovery after surgery (ERAS) and its applicability for major spine surgery. Best Pract Res Clin Anaesthesiol 30:91\u2013102, 20162703660610.1016\/j.bpa.2015.11.001"},{"key":"b35","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1093\/neuros\/nyx400","article-title":"Reduced acute care costs with the ERAS\u00ae minimally invasive transforaminal lumbar interbody fusion compared with conventional minimally invasive transforaminal lumbar interbody fusion","volume":"83","author":"Wang MY","year":"2018","unstructured":"Wang MY, Chang HK, Grossman J: Reduced acute care costs with the ERAS\u00ae minimally invasive transforaminal lumbar interbody fusion compared with conventional minimally invasive transforaminal lumbar interbody fusion. Neurosurgery 83:827\u2013834, 201810.1093\/neuros\/nyx40028945854"},{"key":"b36","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"411","DOI":"10.3171\/2016.9.SPINE16375","article-title":"Development of an Enhanced Recovery After Surgery (ERAS) approach for lumbar spinal fusion","volume":"26","author":"Wang MY","year":"2017","unstructured":"Wang MY, Chang PY, Grossman J: Development of an Enhanced Recovery After Surgery (ERAS) approach for lumbar spinal fusion. J Neurosurg Spine 26:411\u2013418, 201710.3171\/2016.9.SPINE16375"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/46\/4\/article-pE6.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/46\/4\/article-pE6.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/46\/4\/article-pE6.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T08:44:39Z","timestamp":1780130679000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/46\/4\/article-pE6.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":72,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2019.1.focus18669","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4]]}}}