{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T07:31:03Z","timestamp":1792654263387,"version":"4.5.0"},"reference-count":82,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,31]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Enhanced recovery after surgery (ERAS) has demonstrated benefits across various surgical specialties. However, a significant research-practice gap remains, with fewer than half of spine surgeons incorporating ERAS principles into daily practice. A key barrier to ERAS implementation in spine surgery is postoperative compliance, as patients often express concerns about worsening pain. To address these challenges, the authors developed a standardized, delivery-focused ERAS clinical pathway (CP) for oblique lumbar interbody fusion (OLIF). This study prospectively evaluated whether ERAS-CP can improve postoperative compliance without compromising pain control compared with conventional ERAS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This prospective, randomized noninferiority trial involved 41 patients undergoing OLIF from July 2023 to February 2024. Patients were randomized to either the ERAS-CP group (n = 21) or the control (conventional ERAS) group (n = 20). The ERAS-CP comprised a CP system integrated into the electronic health record system, patient education manual, and dedicated medical personnel support. The control group (conventional ERAS) followed standard ERAS principles but lacked these structured compliance-enhancing interventions. The primary outcome was back pain at discharge measured by the numeric rating scale. Secondary outcomes included ERAS compliance, pain management, and patient satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Demographics were similar between the groups. The ERAS-CP group demonstrated noninferiority in back pain at discharge compared with the control group in the intent-to-treat analysis (difference \u22120.1, 95% CI \u22121.4 to 1.1) and the per-protocol analysis (difference \u22120.3, 95% CI \u22121.6 to 1.0). The ERAS-CP group achieved earlier ambulation (median 2 [range 1\u20139] vs 3.5 [range 2\u201318] hours, p = 0.011) and longer daily ambulation times (mean 91.7 vs 68.2 minutes\/day, p = 0.047). Nonopioid analgesic use was higher in the ERAS-CP group on postoperative days 1 and 2 (p &lt; 0.05), with no difference in opioid use. Both groups reported high satisfaction with pain management (78%). No significant differences were found in complication rates, length of stay, or 3-month clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The ERAS-CP for OLIF demonstrated noninferiority in pain management while improving adherence to key ERAS components. By reinforcing postoperative compliance through structured interventions, ERAS-CP may enhance recovery in lumbar spinal fusion surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.7.spine25357","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T20:53:25Z","timestamp":1763412805000},"page":"205-215","source":"Crossref","is-referenced-by-count":1,"title":["Enhanced recovery after surgery clinical pathway in oblique lumbar interbody fusion: overcoming postoperative pain to improve compliance and recovery. A prospective randomized noninferiority trial"],"prefix":"10.3171","volume":"44","author":[{"given":"Jun-Hoe","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Seoul National University Hospital, Seoul;"},{"name":"Department of Neurosurgery, Seoul National University College of Medicine, Seoul;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minjung","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Medical Statistics, Medical Research Collaborating Center, Seoul National University Hospital, Seoul;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan Woo","family":"You","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Seoul National University Hospital, Seoul;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hangeul","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Seoul National University Hospital, Seoul;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Hwan","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Armed Forces Capital Hospital, Seongnam, Republic of Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Rhee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Hyun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Seoul National University Hospital, Seoul;"},{"name":"Department of Neurosurgery, Seoul National University College of Medicine, Seoul;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun Kee","family":"Chung","sequence":"additional","affiliation":[{"name":"Neuroscience Research Institute, Seoul National University College of Medicine, Seoul;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunhee","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Medical Statistics, Medical Research Collaborating Center, Seoul National University Hospital, Seoul;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Heon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Seoul National University Hospital, Seoul;"},{"name":"Department of Neurosurgery, Seoul National University College of Medicine, Seoul;"},{"name":"Department of Medical Device Development, Seoul National University College of Medicine, Seoul; and"},{"name":"Interdisciplinary Program in Neuroscience, Seoul National University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"Br J Anaesth","first-page":"606","article-title":"Multimodal approach to control postoperative pathophysiology and rehabilitation","volume":"78","author":"Kehlet H","year":"1997","unstructured":"Kehlet H. 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