Application Of Enhanced Recovery After Surgery In Percutaneous Transforaminal Endoscope-assisted Lumbar Interbody Fusion

Objective:To explore the application effects of enhanced recovery after surgery(ERAS)in percutaneous transforaminal endoscope-assisted lumbar interbody fusion(PT-Endo-LIF)in the treatment of lumbar degenerative diseases(LDD).Methods:From October 2017 to February 2019,90 patients were diagnosed as the LDD,and was performed by PT-Endo-LIF.All patients were divided into two groups according to randomized number table: the control group(n=45)and the ERAS group.General information of patients,operation time,off-bed time,hospital stay and perioperative complications were recorded.Visual Analogue Scale(VAS),the Japanese Orthopaedic Association scores(JOA)and Oswestry Disability Index(ODI)to evaluate the pain and lumbar functions.The Likert scale was used to evaluate the patients’ satisfaction.Clinical outcomes were evaluated using Mac Nab criteria at the last follow-up.The imaging fusion rate was evaluated by modified Bridwell classification.Results:All patients were successfully discharged from hospital and were followed up for at least 12 months.There was no significant difference in gender,age,BMI,preoperative diagnosis,operation segment,intraoperative bleeding and operation time between the two groups(P>0.05).Off-bed time and hospital stay in the experimental group were lower / shorter than those in the control group with statistical significance(P<0.05).VAS,JOA and ODI of the experimental group [3 days follow-up;1month follow-up] were better than those of the control group with statistical significance(P<0.05).No segment error,vascular and nerve injury,dural sac tear,nerve root tear,postoperative intervertebral space infection,cerebrospinal fluid leakage and other serious complications.Patient’s Satisfaction in the experimental group [3 days follow-up,1month follow-up,last follow-up] were better than those of the control group.The excellent and good rate of the experimental group at the last follow-up was higher than that of the control group.At the last follow-up,according to the modified Bridwell grade,all patients achieved solid fusion(100%).There was no significant difference in imaging fusion rate between the two groups(P>0.05).Conclusions:ERAS nursing mode decreases off-bed time,hospital stay,pain and perioperative complications in the treatment of LDD in patients after PT-Endo-LIF.