Retrospective evaluation of ERAS-guided rehabilitation nursing in anterior cervical discectomy and fusion patients

Purpose This study aimed to evaluate the efficacy of an ERAS-based perioperative nursing pathway in patients undergoing anterior cervical discectomy and fusion (ACDF). Methods A retrospective analysis was conducted on 156 ACDF patients (2022–2024), with 80 in the ERAS group and 76 in the control group. The ERAS group received interdisciplinary care including preoperative nutritional optimization, intraoperative hemodynamic stabilization, early mobilization, and multimodal analgesia. Primary endpoints: time to first flatus and length of hospital stay. Secondary endpoints: time to first defecation, time to first solid food intake, VAS pain scores (resting/moving), urinary catheter removal time, first ambulation time, JOA, NDI, PONV, and complications. Statistical analyses compared outcomes between groups using t -tests and chi-squared tests. Results The ERAS group demonstrated significantly shorter times to first flatus (7.89 ± 2.35 vs. 12.56 ± 4.12 h, P < 0.001), defecation (15.92 ± 5.34 vs. 22.89 ± 7.23 h, P < 0.001), and solid food intake (8.87 ± 2.42 vs. 13.58 ± 3.56 h, P < 0.001). Resting and dynamic VAS scores were lower in the ERAS group ( P < 0.001 for both), with shorter urinary catheter removal time (8.36 ± 2.01 vs. 14.25 ± 3.72 h, P < 0.001), first ambulation time (9.27 ± 2.34 vs. 15.34 ± 4.18 days, P < 0.001), and hospital stay (6.35 ± 1.89 vs. 8.12 ± 2.15 days, P = 0.002). At 3 months, the ERAS group showed better JOA scores (16.12 ± 1.03 vs. 15.33 ± 0.98, P < 0.05) and lower NDI (8.96 ± 1.32 vs. 10.15 ± 0.60, P < 0.05). Complications (e.g., dysphagia, infection) did not differ significantly between groups ( P = 0.221). Conclusion Enhanced recovery after surgery-guided nursing improves gastrointestinal function, reduces pain, and accelerates functional recovery in ACDF patients without increasing complications. This interdisciplinary approach enhances perioperative care efficiency and supports patient-centered outcomes.