Department of Neurological Surgery, University of Virginia Health System, Charlottesville, VA, USA.
Spinal Cord. 2019 Sep;57(9):729-738. doi: 10.1038/s41393-019-0335-8. Epub 2019 Jul 29.
Enhanced recovery after surgery (ERAS) is an evidence-based approach developed to ameliorate the patient recovery process following surgical procedures. Employing a multimodal, multidisciplinary approach, ERAS implements strategies and treatment paradigms that have been shown to improve patient outcomes, reduce hospital length of stay, and ultimately reduce healthcare costs. With a substantial body of the literature supporting the implementation of ERAS in other surgical specialties, ERAS has only recently made its foray into spine surgery. Despite this, current studies are limited to spinal deformity and degenerative disease, with limited data regarding spinal cord surgery. This is due in part to the complex nature and rarity of spinal cord lesions, making the establishment of a formal ERAS protocol difficult. In developing an ERAS protocol, there must be a consensus on what factors are important to consider and implement. To address this, we reviewed the most recent advances in intramedullary and extramedullary spinal cord surgery in order to identify elements that influence patient outcomes. Using this information, the authors provide evidence-based recommendations with the intent of introducing a framework for future ERAS protocols with respect to treating spinal cord lesions.
术后加速康复（ERAS）是一种循证方法，旨在改善手术患者的康复过程。采用多模式、多学科方法，ERAS 实施了已被证明可改善患者预后、缩短住院时间并最终降低医疗成本的策略和治疗模式。大量文献支持在其他外科专业中实施 ERAS，而 ERAS 最近才刚刚涉足脊柱外科。尽管如此，目前的研究仅限于脊柱畸形和退行性疾病，关于脊髓手术的数据有限。部分原因是脊髓病变的复杂性和罕见性，使得制定正式的 ERAS 方案变得困难。在制定 ERAS 方案时，必须就哪些因素是重要的考虑因素和实施因素达成共识。为了解决这个问题，我们回顾了最近在脊髓内和脊髓外脊柱手术方面的进展，以确定影响患者预后的因素。利用这些信息，作者提供了循证建议，旨在为未来治疗脊髓病变的 ERAS 方案引入一个框架。
