Enhanced Recovery After Spine Surgery

Enhanced Recovery After Spine Surgery: A Prospective Randomized Controlled Trial to Assess Quality of Recovery and the Biochemical Stress Response to Lumbar Fusion

Enhanced recovery pathways (ERP) after surgery have been shown to decrease length of stay and perioperative complications in a range of surgical specialties. To date, ERPs has not been studied in patients presenting for spine surgery. The investigators have recently developed an interdisciplinary pathway for spine surgery patients based on the latest available evidence and guidelines. The aim of this trial is to compare the investigators enhanced recovery pathway with conventional perioperative management in patients undergoing 1-2 level posterior lumbar fusion.

Inclusion Criteria:

• Any patient presenting for 1 or 2 level posterior lumbar fusion.

Exclusion Criteria:

• Cognitive impairment (baseline dementia, cognitive dysfunction or inability to consent to participate).
• Kidney disease: GFR <60 mL/min/1.73 m2 for 3 months or more, irrespective of cause (Levey et al., 2012).
• Liver disease: transaminitis, cirrhosis, hepatitis, hypoalbuminemia, coagulopathy.
• Pre-existing bowel disease (inflammatory bowel disease, colectomy/ colostomy/diverticular disease).
• Allergy/intolerance/contraindication to any medication or component included in the ERAS pathway protocol.
• Patients whose primary or preferred language is not English.