Our Summary

The study looked at the effectiveness of the Enhanced Recovery After Surgery (ERAS) program in minimally invasive back surgery called microdiscectomy. The researchers compared two groups of patients - those who underwent surgery before the ERAS program was implemented (140 patients) and those who had surgery after the program was in place (286 patients).

The findings showed that the ERAS program helped patients to recover faster after surgery. Patients in the ERAS group spent less time in the hospital, had lower costs, and used fewer painkillers compared to those in the conventional group. Moreover, there were no significant differences in pain levels, complications, or rates of patients needing to be readmitted or operated on again within 30 days between the two groups.

In simple terms, the ERAS program seems to be beneficial for patients undergoing microdiscectomy surgery, as it helps to speed up recovery, reduce hospital stay, cut down costs, and lower the use of opioids for pain relief.

FAQs

  1. What is the Enhanced Recovery After Surgery (ERAS) program and how does it affect patients undergoing microdiscectomy surgery?
  2. What were the key differences observed between patients who had surgery before and after the implementation of the ERAS program?
  3. Did the ERAS program have any impact on pain levels, complications, or rates of patients needing to be readmitted or operated on again within 30 days?

Doctor’s Tip

A doctor might tell a patient undergoing microdiscectomy surgery to inquire about the Enhanced Recovery After Surgery (ERAS) program, as it has been shown to help patients recover faster, reduce hospital stay, lower costs, and decrease the need for painkillers. It is important to discuss this option with your healthcare team to see if it is a suitable option for you.

Suitable For

Typically, patients who are recommended for microdiscectomy surgery are those who have a herniated or bulging disc in the lumbar spine that is causing nerve compression and symptoms such as leg pain, numbness, or weakness. These patients may have tried conservative treatments such as physical therapy, medications, and injections without success, and their symptoms are significantly impacting their quality of life.

Microdiscectomy is considered a minimally invasive procedure that involves removing the portion of the disc that is pressing on the nerve, allowing the nerve to heal and relieving the symptoms. It is often recommended for patients who have not responded to conservative treatments and whose symptoms are severe enough to warrant surgical intervention.

Overall, patients who are in good overall health, have realistic expectations for surgery, and have exhausted conservative treatment options may be good candidates for microdiscectomy surgery. The ERAS program, as shown in the study, can help improve outcomes for these patients by promoting faster recovery and reducing the need for opioids for pain management.

Timeline

Before microdiscectomy:

  1. Patient experiences chronic back pain, leg pain, and possible weakness or numbness in the legs.
  2. Patient undergoes diagnostic tests such as MRI or CT scan to determine the cause of the symptoms.
  3. Patient consults with a spine surgeon who recommends microdiscectomy as a treatment option.
  4. Patient undergoes preoperative evaluation and preparation for surgery.

After microdiscectomy:

  1. Patient undergoes microdiscectomy surgery to remove the herniated disc material pressing on the nerve.
  2. Patient is monitored in the recovery room before being transferred to a hospital room.
  3. Patient follows a postoperative plan including pain management, physical therapy, and restrictions on activities.
  4. Patient is discharged from the hospital and continues to recover at home.
  5. Patient follows up with the surgeon for postoperative appointments and rehabilitation.
  6. Patient gradually resumes normal activities and experiences relief from back and leg pain.

What to Ask Your Doctor

Some questions a patient should ask their doctor about microdiscectomy include:

  1. What are the risks and benefits of undergoing a microdiscectomy procedure?
  2. What is the success rate of microdiscectomy in relieving my specific symptoms?
  3. How long is the recovery process after a microdiscectomy surgery?
  4. Will I need physical therapy or rehabilitation after the surgery?
  5. What are the potential complications or side effects of the surgery?
  6. How long will I need to stay in the hospital after the procedure?
  7. Will the ERAS program be implemented for my surgery, and how will it benefit me?
  8. Will I need to take painkillers after the surgery, and for how long?
  9. What restrictions or limitations will I have after the surgery?
  10. What is the likelihood of needing additional surgery in the future after a microdiscectomy procedure?

Reference

Authors: Lu Y, Long J, Leng X, Zhang Y, Wang G, Yuan J, Liu L, Fu J, Yang M, Chen Y, Li C, Zhou Y, Feng C, Huang B. Journal: BMC Surg. 2023 Aug 29;23(1):259. doi: 10.1186/s12893-023-02130-3. PMID: 37644499