Perioperative medicine & outcomes
Optimising postoperative spine outcomes: an umbrella review of enhanced recovery after spinal surgery (ERAS for spinal surgery (ERASS)) protocols
Authors' conclusion
ERASS protocols significantly improve surgical efficiency and safety.
Study context
- Population
- Patients undergoing spinal surgery
- Participants
- 221,605 patients · 17 systematic reviews (SRs) · 55 meta-analyses (MAs) · 319 studies
- Comparison
- ERASS protocols vs conventional care
- Outcome
- LOS, postoperative complications, readmission rates, healthcare costs, pain scores, opioid consumption
Methodological detailsAMSTAR-2 and ROBIS quality assessment, overlapping primary studies removed, fixed or random-effects models
- AMSTAR-2 and ROBIS quality assessment
- Overlapping primary studies removed
- Fixed or random-effects models
Pooled result
As reported in the abstract
Primary outcomes: LOS, postoperative complications, readmission rates, healthcare costs, pain scores, opioid consumption
ERASSDifference, days (95% CI)P value
LOS
−1.55(−1.83 to −1.27)
P < 0.01ERASSRelative risk (95% CI)P value
Postoperative complications
0.61(0.52–0.72)
P < 0.01ERASSDifference, mg morphine equivalents (95% CI)P value
Opioid consumption
−7.26(−10.82 to −3.70)
P < 0.01- Healthcare costs
- difference -$1029.41 per patient (95% CI -$1630.17 to -$428.65); P < 0.01
- Pain scores: modest, non-significant reduction
- −0.27 (−0.27; 95% CI −0.66 to 0.13; P=0.19)
Original publication
Optimising postoperative spine outcomes: an umbrella review of enhanced recovery after spinal surgery (ERASS) protocols. Br J Anaesth. Published 8 October 2025. doi:10.
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