Enhanced recovery after surgery for microsurgical oblique lateral interbody fusion: A retrospective before-and-after cohort study.

Authors

Jie Chen, Huaxi Li, Lingyun Qiu, Xinghui Xie, Xia Qin

Published in

Medicine. Volume 105. Issue 41. Pages e51016. Oct 09, 2026.

Abstract

This study evaluates the real-world effectiveness and safety of a standardized enhanced recovery after surgery (ERAS) pathway in patients undergoing single-level microsurgical oblique lateral interbody fusion (MIS-OLIF) for lumbar degenerative disease. This retrospective before-and-after cohort study included 89 patients who underwent single-level MIS-OLIF at L3-4 or L4-5 between January 2021 and December 2023. Patients were categorized according to the institutional perioperative pathway in effect at the time of surgery: conventional care (n = 44) or ERAS (n = 45). The primary outcome was postoperative length of stay. Secondary outcomes included back-pain and leg-pain visual analog scale (VAS) scores, Oswestry Disability Index (ODI), ERAS-component adherence, discharge readiness, complications, readmission, and patient satisfaction. Selection bias was addressed using propensity-score overlap weighting, and repeated VAS and ODI measurements were analyzed using linear mixed-effects models. The ERAS group had a shorter unadjusted hospital stay than the conventional-care group (6.2 ± 0.8 vs 7.5 ± 1.2 days). After overlap-weighting adjustment, ERAS was associated with an adjusted reduction in postoperative length of stay of -1.1 days (95% confidence interval [CI]: -1.4 to -0.8; P < .001). Early postoperative back and leg pain were significantly lower in the ERAS group (group-by-time interaction P = .02 and P = .04, respectively). Overall ERAS adherence was 94.7% (median). Complication rates were 11.1% vs 18.2% (adjusted odds ratio 0.52, 95% CI: 0.14-1.94, P = .33), and satisfaction rates (satisfied/very satisfied) were 97.8% vs 93.2% (P = .36). In this single-center real-world cohort, implementation of a standardized ERAS pathway was associated with earlier discharge after single-level MIS-OLIF. The effects on pain, function, satisfaction, and safety should be interpreted according to the adjusted analyses and remain subject to residual confounding inherent in the retrospective before-and-after design.

PMID:
42854070
Bibliographic data and abstract were imported from PubMed on 10 Oct 2026.

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