Impact of enhanced recovery after surgery (ERAS) protocols on clinical outcomes of patients undergoing anterior cervical discectomy and fusion: A retrospective study

This study aimed to evaluate the impact of enhanced recovery after surgery (ERAS) protocols on the clinical outcomes of anterior cervical discectomy and fusion (ACDF). This retrospective study included eligible patients with 3-level cervical disc herniation treated with ACDF between April 2020 and April 2022, with a minimum 1-year follow-up. Patients were categorized into 2 groups based on whether they received an ERAS protocol (ERAS+ group) or standard perioperative care (ERAS− group). Key outcome measures included hospital length of stay, total cost, estimated blood loss, visual analogue scale pain scores, Neck Disability Index, Japanese Orthopaedic Association scores, perioperative opioid usage, complication rates, and Bridwell bone fusion grades. Statistical analyses were performed using Statistical Package for Social Sciences 24.0, with significance set at P < .05. The implementation of an ERAS protocol in patients undergoing multilevel ACDF may be associated with improved perioperative metrics, enhanced functional recovery, reduced opioid use, and lower complication rates in this retrospective analysis. Further prospective studies are warranted to confirm these observations. A total of 110 eligible patients were enrolled in our study. Compared with the ERAS− group, the ERAS+ group demonstrated significantly shorter hospital stays (3.6 ± 0.5 vs 4.3 ± 0.8 days, P < .05), lower total costs (18,569.2 ± 872.4 vs 21,201.9 ± 1160.8 CNY, P < .05), and reduced estimated blood loss (75.5 ± 14.6 vs 107.2 ± 27.5 mL, P < .05). The ERAS+ group also showed superior improvements in visual analogue scale, Neck Disability Index, and Japanese Orthopaedic Association scores at follow-up visits ( P < .05). Furthermore, the ERAS+ group had significantly lower perioperative opioid consumption, a lower incidence of overall complications ( P < .05), and better Bridwell fusion grades ( P < .05).