MATERIAL and METHODS: This study described the introduction of the ERSS program, and we compared 86 consecutive patients who participated in ERSS with a retrospective cohort of 88 patients who underwent the same surgery before the implementation of this program.

Groups were compared in terms of age, sex, body mass index (BMI), American Society of Anesthesiologist (ASA) physical scores, operative time, comorbidities, intraoperative blood loss, blood transfusion rate, first oral intake, time of first mobilization, length of hospital stay, preoperative and postoperative pain scores using a numeric pain rating scale, 30-day readmission and complication rates, and total cost.

RESULTS: Groups were similar in terms of age, sex, BMI, ASA scores, and comorbidities. Intraoperative blood loss, blood transfusion rate, and length of hospital stay were lower in the ERSS group. First oral intake and first mobilization occurred earlier in the ERSS group. Postoperative pain scores were significantly lower in the ERSS group. Operative time, readmissions, or complications at 30 days did not statistically differ between the two groups. The ERSS group was found to be significantly cost effective.

CONCLUSION: ERSS is feasible, comprehensive, and cost effective for spine instrumentation with better perioperative outcomes. Keywords : Enhanced recovery, ERSS, Spine surgery, Perioperative outcomes, Cost analysis