Application and feasibility of an enhanced recovery after surgery pathway in the perioperative management of early-onset scoliosis
DING Zi-hao
DING Hong-tao
CHENG Yun-zhong
ZHANG Yao-shen
LIU Yu-zeng
HAI Yong
Abstract：Objective To evaluate the effectiveness and feasibility of enhanced recovery after surgery(ERAS)pathway in patients with early-onset scoliosis(EOS)undergoing posterior growing-rod fusion.Methods We retrospectively reviewed 70 EOS patients(25 males,45 females;age 10-16 years;osteotomy grade≤3)who underwent posterior growing-rod fusion at our institution between June 2014 and May 2023.Patients were managed either by an ERAS protocol or a traditional perioperative pathway(TP).Demographic and perioperative data collected included age,sex,height,weight,body mass index(BMI),pre-and postoperative hemoglobin levels,EOS etiology,intraoperative blood loss,number of fused segments,and number of pedicle screws.Postoperative outcomes comprised visual analog scale(VAS)pain scores(post-op days 1 and 3),drainage volume and duration,duration of analgesic use,time to first ambulation,length of hospital stay,and incidence of complications.Radiographic parameters included pre-and postoperative main-curve Cobb's angle and correction rate.Results Both groups achieved satisfactory deformity correction.In the ERAS cohort,the main-curve Cobb's angle improved from(89.03±12.51)° to(46.74±7.41)°,while the TP group improved from(84.86±10.53)° to(44.69±4.66)°.Estimated blood loss was significantly lower in the ERAS group(P<0.001).Postoperative VAS scores on days 1 and 3 were significantly reduced in the ERAS group compared with TP(P<0.001).Postoperative hemoglobin levels were higher in ERAS patients(P<0.001).The ERAS group also demonstrated significantly less drainage volume,shorter drainage duration,and reduced duration of analgesic use(all P<0.001).Furthermore,time to first ambulation and overall hospital stay were significantly shorter in the ERAS cohort(P<0.001).The incidence of postoperative complications(wound infection,nausea/vomiting,fever,anemia)was lower in the ERAS group.Conclusions Implementation of ERAS pathway in EOS correction surgery effectively reduces intraoperative blood loss,alleviates postoperative pain,decreases complication rates,and accelerates recovery,resulting in shorter hospitalization.
Keywords：ScoliosisAdolescentEnhanced recovery after surgeryPerioperative period
Publication Date：2025-10-19
Online Publishing Date：2025-11-06(First online date of this platform, not the publication date of the document)
Pages：7( 896-902 )