Introduction. Enhanced recovery after surgery (ERAS) in spine

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The practice of spinal surgery has often been associated with a long and painful recovery for the patient. This can be due to numerous factors, including the nature of the surgical procedure itself; the treatment of multiple motion segments; premorbid conditions such as narcotic dependence; deconditioning; and preoperative psychological priming. Judged from the economic, physiological, and social perspectives, we as spinal surgeons understand that opportunities exist for improving the patient’s experience when undergoing a spinal operation.

The principle of enhanced recovery after surgery (ERAS) was initially developed in Western Europe for abdominal surgery. Since its inception 2 decades ago, the proliferation of ERAS programs has been impressive, involving numerous subspecialties on 6 continents, and there are now societies focused on this aspect of care across specialties. However, neurosurgery and spinal surgery have been late to the game.

For practicing surgeons there has been increased demand for improvement in perioperative care, and many institutions have attempted to implement ERAS programs throughout their hospitals across disciplines. Thus, there has been a disconnect between many healthcare institutions and their spine surgeons due to a lack of data on how to begin or to implement a spinal ERAS program. It is in this vacuum that we have decided to dedicate a Neurosurgical Focus issue to ERAS in spine surgery. The earliest ERAS programs have now begun collecting data that in many cases demonstrate the effectiveness of these approaches as measured by diverse metrics. However, we are only at the nascent stages of ERAS in spinal surgery, and this issue will likely serve as most neurosurgeons’ first exposure to this important and growing area of research.

Disclosures

Dr. Wang reports being a consultant for DePuy-Synthes Spine, K2M, Spineology, and Stryker; receiving royalties from Children’s Hospital of Los Angeles, DePuy-Synthes Spine, Springer Publishing, and Quality Medical Publishing; being a member of the board at Vallum; and holding stock in Innovative Surgical Devices and Medical Device Partners. Dr. Tessitore reports being a consultant for DePuy Synthes, NuVasive, Brainlab, and Spineart and receiving training fees from DePuy Synthes, NuVasive, and Spineart. Dr. Dailey reports being a consultant for Zimmer Biomet and K2M; receiving support for non–study-related clinical or research work he oversees; and receiving an honorarium from AO North America.

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Article Information

Correspondence Michael Y. Wang: mwang2@med.miami.edu.

INCLUDE WHEN CITING DOI: 10.3171/2019.1.FOCUS1957.

Disclosures Dr. Wang reports being a consultant for DePuy-Synthes Spine, K2M, Spineology, and Stryker; receiving royalties from Children’s Hospital of Los Angeles, DePuy-Synthes Spine, Springer Publishing, and Quality Medical Publishing; being a member of the board at Vallum; and holding stock in Innovative Surgical Devices and Medical Device Partners. Dr. Tessitore reports being a consultant for DePuy Synthes, NuVasive, Brainlab, and Spineart and receiving training fees from DePuy Synthes, NuVasive, and Spineart. Dr. Dailey reports being a consultant for Zimmer Biomet and K2M; receiving support for non–study-related clinical or research work he oversees; and receiving an honorarium from AO North America.

© AANS, except where prohibited by US copyright law.

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