The Application Study Of The Concept Of Accelerated Rehabilitation Surgery (ERAS) In The Perioperative Period Of Osteoporotic Vertebral Compression Fractures

Objective:To explore the application of the concept of ERAS(enhanced recovery after surgery,ERAS)in the perioperative period of osteoporotic vertebral compression fracture(OVCF),and to develop a safe,reliable and efficient individualized treatment process and program for the rapid diagnosis and rehabilitation of OVCF.Finally,the application of ERAS in spinal surgery was explored and verified.Method:A total of 120 osteoporotic vertebral compression fracture patients admitted to the spine Department of Sichuan Provincial Orthopedic Hospital from September 2017 to September 2018 were collected.All patients met the inclusion criteria,and the two groups were randomly divided into observation group and control group by digital table method.There was no significant difference in the basic data before operation between the two groups(P > 0.05).The observation group was treated with enhanced recovery after surgery(ERAS)concept,while the control group was treated with routine procedures.The hospitalization time,preoperative preparation time,cement leakage rate,complication rate,patient satisfaction,single vertebral puncture time,X-ray exposure time(fluoroscopy times),absolute value and percentage of vertebral height recovery were statistically described.VAS(Visual Analogue Scale,VAS)score was used to evaluate the degree of pain in patients;ODI(Oswestry Disability Index,ODI)score was used to evaluate the degree of daily activity dysfunction and the results of preoperative.The results of preoperative,1 day,1 month,3 months,6 months and the last follow-up after operation were compared within and between groups.Results:All patients were followed up for(10.1 + 3.0)months.There was no significant difference in the absolute value and percentage of vertebral height recovery between the two groups(P > 0.05)in terms of cement leakage rate,single vertebral puncture time,X-ray exposure time(fluoroscopy times)(preoperative,1 day,1 month,3 months,6 months,and the last follow-up after operation).The hospitalization time,preoperative preparation time,complication rate,VAS pain score and patient satisfaction in the observation group were all significant better than the control group,the difference was statistically significant(P < 0.05).The VAS and ODI scores of the observation group at 1 day,1 month and 3 months after operation were better than those of the control group,the difference was statistically significant(P < 0.05),but there was no significant difference between the two groups at 6 months and the last follow-up(P > 0.05).Conclusions:ERAS is a comprehensive management system of multi-disciplinary cooperation.It is not a specific treatment method,but a concept.This study shows that the application of the concept of ERAS in the perioperative period of osteoporotic vertebral compression fracture is remarkable and safe;it can effectively alleviate patients' pain,shorten hospitalization time,greatly reduce the incidence of complications and significantly improve patient satisfaction;it is worth promoting in spine surgery,especially in the field of orthopaedics,and has great application prospects.