Enhanced recovery after surgery (ERAS) program for elderly patients with anterior cervical discectomy and fusion (ACDF)

Background: Enhanced recovery after surgery (ERAS) is currently widely used in in many surgical specialties, but it is still lack of concerning the cervical ERAS program for elderly patients (>60 years old). We aimed to determine whether our ERASprogram significantly improved satisfaction and outcomes in elderly patients (>60 years old) with anterior cervical discectomy and fusion (ACDF). Methods: : The study enrolled patients if they were over the age of 60 years old underwent under four levels ACDF. Data including demographic, comorbidity and surgical information were collected. We also evaluated ERAS process compliance, primary outcome, surgical complication and length of stay (LOS). Results: : There were 135 patients in the ERAS group and 122 patients in the non-ERAS group were included. A comparison of the demographic data revealed that there were no statistically significant intergroup differences observed between the group. Overall, ERAS pathway compliance was 91.9%. There were no significant differences in the fusion levels、operative time、intraoperative blood loss、postoperative VAS score and complications between the ERAS and non-ERAS groups. In addition, there was no significant difference in readmission and mortality at 30-day follow-up between the two groups. However, we observed a statistically significant decrease in the LOS in the ERAS group (8.68±2.34 of ERAS group versus 10.43±4.05 in non-ERAS group, p=0.013). Conclusions: : This report describes the first ERAS protocol used in elderly patients with ACDF. Our ERAS program is safe and associated with incremental benefits in respect to LOS in elderly patients with ACDF