Enhanced recovery care versus traditional care following laminoplasty A retrospective case-cohort study

Enhanced recovery after surgery (ERAS) has been shown to shorten length of hospital stay and reduce perioperative complications in many types of surgeries. However, there has been a paucity of research examining the application of ERAS to major spinal surgery. The current study was performed to compare complications and hospital stay after laminoplasty between an ERAS group and a traditional care group. The ERAS group included 114 patients who underwent laminoplasty managed with an ERAS protocol between January 2016 and June 2017. The traditional care group included 110 patients, who received traditional perioperative care between November 2014 and December 2015. Postoperative hospital stay (POPH), physiological function, postoperative visual analogue scale (VAS) pain score, and postoperative complications were compared between the 2 groups. The mean POPH was significantly shorter in the ERAS group than traditional care group (5.75 +/- 2.46 vs. 7.67 +/- 3.45 d, P<.001). ERAS protocol significantly promoted postoperative early food-taking (8.45 +/- 2.94 h vs 21.64 +/- 2.66 h, P<.001), reduced the first time of assisted walking (30.79 +/- 14.45 vs. 65.24 +/- 25.34 h, P<.001), postoperative time of indwelling urinary catheters (24.76 +/- 12.34 vs. 53.61 +/- 18.16 h, P<.001), and wound drainage catheters (43.92 +/- 7.14 vs. 48.85 +/- 10.10 h, P<.001), as compared with the traditional care group. Pain control was better in the ERAS group than traditional care group in terms of mean VAS score (2.72 +/- 0.46 vs. 3.35 +/- 0.46, P<.001) and mean maximum VAS score (3.76 +/- 1.12 vs. 4.35 +/- 1.15, P<.001) in 3 days after surgery. The morbidity rate was 21.05% (24 of 114 patients) in the ERAS group and 20.90% (23 of 110 patients) in the control group (P=.75). The ERAS protocol is both safe and feasible for patients undergoing laminoplasty, and can decrease the length of postoperative hospitalization without increasing the risk of complications.