A novel “Enhanced Recovery After Surgery” (ERAS) protocol developed by Penn Medicine for patients undergoing spinal and peripheral nerve surgery significantly reduced opioid use. A new study published in the Journal of Neurosurgery: Spine showed that when an ERAS protocol was employed—which optimizes patients’ surgical care before, during, and after surgery, including patient education, post-operative medications, and recovery plans—fewer patients needed pain medications one month after surgery.
Nearly 75 percent of patients at Penn Medicine who undergo spinal surgeries are opioid naïve—patients who are not chronically taking opioids on a daily basis—putting them at an increased risk for dependency following surgery. Previous studies have also shown that up to 7 percent of all patients who undergo spinal surgeries continue to take opioids one year after surgery. Part of the ERAS protocol at Penn includes a personalized, safe, and effective pain management plan to help prevent opioid dependency, which has rapidly become a public health crisis in the United States.
Observational cohort study of 137 patients with lumbar spinal pathology; 100 were recommended for lumbar spinal fusion by a surgeon
After evaluation by a multidisciplinary team including PTs, 58 of the 100 were recommended for nonoperative treatment
Authors believe that collaborative evaluation can lead to better outcomes, decrease inappropriate surgical interventions, and decrease costs for patients with lumbar spine problems
Multidisciplinary evaluation and direct communication among providers may offer patients with spine problems “more diverse nonoperative treatment options” and result in fewer unnecessary surgeries, leading to lower costs, experts say. In a pilot study e-published ahead of print in Spine, a team of providers from diverse fields recommended nonoperative treatment for 58% of patients who previously had been advised by a surgeon to undergo spinal fusion.