Salamanna Francesca, Tedesco Giuseppe, Sartori Maria, Contartese Deyanira, Asunis Emanuela, Cini Chiara, Veronesi Francesca, Martikos Konstantinos, Fini Milena, Giavaresi Gianluca, Gasbarrini Alessandro
Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy.
Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy.
Int J Mol Sci. 2025 Apr 15;26(8):3723. doi: 10.3390/ijms26083723.
Limited data exist on the clinical outcomes and inflammatory response of Enhanced Recovery After Surgery (ERAS) protocols in adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF). This study evaluates ERAS's impact by analyzing blood parameters and serum protein, surgical, and radiological parameters to assess safety, feasibility, and clinical outcomes. Between July 2021 and July 2022, 30 AIS patients underwent PSF with standardized pain management, high-dose tranexamic acid, early mobilization, and reduced opioid use. Blood tests and serum markers (IL-6, IL-1β, IL-1α, IL-10, TNF-α, IL-8, PGE2) were measured preoperatively and on postoperative day 2. Pain levels (VAS) were recorded preoperatively, on postoperative days 1 and 2, and at discharge. Results showed increased postoperative white blood cell counts, reduced hemoglobin and hematocrit, and elevated C-reactive protein levels. IL-6 was the only inflammatory marker significantly elevated, indicating a controlled inflammatory response. Pain peaked on day 1 but significantly decreased by discharge, confirming the effectiveness of multimodal analgesia. The average hospital stay was 6.97 ± 2.03 days, with low rehospitalization (6.66%) and manageable complications (20%). In conclusion, ERAS effectively optimizes AIS patient recovery, stabilizing pain, reducing complications, and improving perioperative care.
关于青少年特发性脊柱侧凸(AIS)患者接受后路脊柱融合术(PSF)时采用术后加速康复(ERAS)方案的临床结局和炎症反应的数据有限。本研究通过分析血液参数、血清蛋白、手术参数和放射学参数来评估ERAS的影响,以评估安全性、可行性和临床结局。在2021年7月至2022年7月期间,30例AIS患者接受了PSF,采用了标准化疼痛管理、高剂量氨甲环酸、早期活动和减少阿片类药物使用。术前及术后第2天进行血液检查和血清标志物(IL-6、IL-1β、IL-1α、IL-10、TNF-α、IL-8、PGE2)检测。术前、术后第1天和第2天以及出院时记录疼痛水平(视觉模拟评分法)。结果显示术后白细胞计数增加、血红蛋白和血细胞比容降低以及C反应蛋白水平升高。IL-6是唯一显著升高的炎症标志物,表明炎症反应得到控制。疼痛在第1天达到峰值,但出院时显著降低,证实了多模式镇痛的有效性。平均住院时间为6.97±2.03天,再住院率低(6.66%),并发症可控(20%)。总之,ERAS有效地优化了AIS患者的康复,稳定了疼痛,减少了并发症,并改善了围手术期护理。