BACKGROUND The role of enhanced recovery after surgery (ERAS) pathways implementation has not been previously explored in adult deformity patients. OBJECTIVE To determine the impact of ERAS pathways implementation in adult patients undergoing open thoraco-lumbar-pelvic fusion for degenerative scoliosis on postoperative outcome, opioid consumption, and unplanned readmission rates. METHODS In this retrospective single-center study, we included 124 consecutive patients who underwent open thoraco-lumbar-pelvic fusion from October 2016 to February 2019 for degenerative scoliosis. Primary outcomes consisted of postoperative supplementary opioid consumption in morphine equivalent dose (MED), postoperative complications, and readmission rates within the postoperative 90-d window. RESULTS There were 67 patients in the ERAS group, and 57 patients served as pre-ERAS controls. Average patient age was 69 yr. The groups had comparable demographic and intraoperative variables. ERAS patients had a significantly lower rate of postoperative supplemental opioid consumption (248.05 vs 314.05 MED, P = .04), a lower rate of urinary retention requiring catheterization (5.97% vs 19.3%, P = .024) and of severe constipation (1.49% vs 31.57%, P < .0001), and fewer readmissions after their surgery (2.98% vs 28.07%, P = .0001). CONCLUSION A comprehensive multidisciplinary approach to complex spine surgery can reduce opioid intake, postoperative urinary retention and severe constipation, and unplanned 90-d readmissions in the elderly adult population.

中文翻译：

---

手术后恢复的增强减少了成人退行性畸形的开放胸腰椎融合术后阿片类药物的使用和 90 天的再入院率

背景 先前尚未在成人畸形患者中探索实施加速康复外科 (ERAS) 通路的作用。目的 确定 ERAS 通路在接受开放胸腰椎融合术治疗退行性脊柱侧凸的成年患者中实施对术后结果、阿片类药物消耗和非计划再入院率的影响。方法 在这项回顾性单中心研究中，我们纳入了 2016 年 10 月至 2019 年 2 月因退行性脊柱侧凸接受开放胸腰椎融合术的 124 名连续患者。主要结果包括术后补充阿片类药物的吗啡等效剂量 (MED)、术后并发症和术后 90 天窗口内的再入院率。结果 ERAS组有67例患者，57 名患者作为 ERAS 前对照。患者的平均年龄为 69 岁。各组具有可比较的人口统计学和术中变量。ERAS 患者术后补充阿片类药物消耗率显着降低（248.05 对 314.05 MED，P = .04），需要导尿的尿潴留率（5.97% 对 19.3%，P = .024）和严重便秘（1.49 % 与 31.57%，P < .0001），手术后再入院率较低（2.98% 与 28.07%，P = .0001）。结论 复杂脊柱手术的综合多学科方法可以减少老年人群中阿片类药物的摄入、术后尿潴留和严重便秘以及计划外的 90 天再入院。ERAS 患者术后补充阿片类药物消耗率显着降低（248.05 对 314.05 MED，P = .04），需要导尿的尿潴留率（5.97% 对 19.3%，P = .024）和严重便秘（1.49 % 与 31.57%，P < .0001），手术后再入院率较低（2.98% 与 28.07%，P = .0001）。结论 复杂脊柱手术的综合多学科方法可以减少老年人群中阿片类药物的摄入、术后尿潴留和严重便秘以及计划外的 90 天再入院。ERAS 患者术后补充阿片类药物消耗率显着降低（248.05 对 314.05 MED，P = .04），需要导尿的尿潴留率（5.97% 对 19.3%，P = .024）和严重便秘（1.49 % 与 31.57%，P < .0001），手术后再入院率较低（2.98% 与 28.07%，P = .0001）。结论 复杂脊柱手术的综合多学科方法可以减少老年人群中阿片类药物的摄入、术后尿潴留和严重便秘以及计划外的 90 天再入院。手术后再入院的次数更少（2.98% 对 28.07%，P = .0001）。结论 复杂脊柱手术的综合多学科方法可以减少老年人群中阿片类药物的摄入、术后尿潴留和严重便秘以及计划外的 90 天再入院。手术后再入院的次数更少（2.98% 对 28.07%，P = .0001）。结论 复杂脊柱手术的综合多学科方法可以减少老年人群的阿片类药物摄入、术后尿潴留和严重便秘以及计划外的 90 天再入院。