# Retrospective evaluation of ERAS-guided rehabilitation nursing in anterior cervical discectomy and fusion patients

## TL;DR

This study shows that ERAS-guided nursing improves recovery and reduces hospital stays for patients undergoing cervical spine surgery.

## Contribution

The study provides empirical evidence that ERAS-based interdisciplinary nursing improves postoperative outcomes in ACDF patients.

## Key findings

- ERAS group had significantly shorter times to first flatus, defecation, and solid food intake.
- ERAS group showed lower pain scores and faster urinary catheter removal and ambulation times.
- Improved functional scores (JOA and NDI) at 3 months with no increase in complications.

## Abstract

This study aimed to evaluate the efficacy of an ERAS-based perioperative nursing pathway in patients undergoing anterior cervical discectomy and fusion (ACDF).

A retrospective analysis was conducted on 156 ACDF patients (2022–2024), with 80 in the ERAS group and 76 in the control group. The ERAS group received interdisciplinary care including preoperative nutritional optimization, intraoperative hemodynamic stabilization, early mobilization, and multimodal analgesia. Primary endpoints: time to first flatus and length of hospital stay. Secondary endpoints: time to first defecation, time to first solid food intake, VAS pain scores (resting/moving), urinary catheter removal time, first ambulation time, JOA, NDI, PONV, and complications. Statistical analyses compared outcomes between groups using t-tests and chi-squared tests.

The ERAS group demonstrated significantly shorter times to first flatus (7.89 ± 2.35 vs. 12.56 ± 4.12 h, P < 0.001), defecation (15.92 ± 5.34 vs. 22.89 ± 7.23 h, P < 0.001), and solid food intake (8.87 ± 2.42 vs. 13.58 ± 3.56 h, P < 0.001). Resting and dynamic VAS scores were lower in the ERAS group (P < 0.001 for both), with shorter urinary catheter removal time (8.36 ± 2.01 vs. 14.25 ± 3.72 h, P < 0.001), first ambulation time (9.27 ± 2.34 vs. 15.34 ± 4.18 days, P < 0.001), and hospital stay (6.35 ± 1.89 vs. 8.12 ± 2.15 days, P = 0.002). At 3 months, the ERAS group showed better JOA scores (16.12 ± 1.03 vs. 15.33 ± 0.98, P < 0.05) and lower NDI (8.96 ± 1.32 vs. 10.15 ± 0.60, P < 0.05). Complications (e.g., dysphagia, infection) did not differ significantly between groups (P = 0.221).

Enhanced recovery after surgery-guided nursing improves gastrointestinal function, reduces pain, and accelerates functional recovery in ACDF patients without increasing complications. This interdisciplinary approach enhances perioperative care efficiency and supports patient-centered outcomes.