Abstract
INTRODUCTION
Enhanced recover after surgery (ERAS) programs have been utilized by surgeons across the globe, but its implementation in cervical spine surgery (CSS) has been limited. ERAS programs have been associated with beneficial patient outcomes, shorter hospital stays, and quicker recovery periods. We developed a cervical spine care pathway which was applied to all outpatients undergoing surgery. In principle the CSS pathway should minimize complications, reduce the length of stay, and improve the outcomes of cervical spine surgery patients.
METHODS
The pathway was divided into 3 phases preoperative, perioperative and postoperative. We looked at LOS, mortality, complications, and 30-d readmissions. One year of data was collected and compared to national published data. Outcome measurements and demographics were retrieved from the electronic health record (EHR) of each patient by a blinded independent reviewer. All surgeries were performed by a single surgeon at a single institution.
RESULTS
There were 144 cervical cases that were included in this study. Out of the 144 total patients, 43 had a single-level procedure, while 101 had a multi-level procedure. Patients who followed the Cervical Spinal Pathways were found to have significantly reduced LOS, mortality, complications, and readmission rates compared to national averages. LOS was significantly affected by preoperative activity level and postoperative complications. Patients who were not ambulatory preoperative had a longer length of stay while inpatient rehab placement was arranged.
CONCLUSION
CSS pathways should be used in spinal surgeries to improve post-surgical outcomes. Individual items within the ERAS pathway need to be studied independently to determine the significance of each factor on surgical outcomes.
Factors Affecting Length of Stay Following Elective Anterior and Posterior Cervical Spine Surgery
