ERAS on Cervical Surgery

Study Overview
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Brief Summary
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This study is to evaluate the application effect of the concept of accelerated rehabilitation surgery in the perioperative period of patients with cervical spondylosis through a retrospective cohort study

Detailed Description
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To evaluate the effect of a series of optimization measures in ERAS among the patients during perioperative period who underwent cervical surgery. Methods: A retrospective cohort study was conducted for the patients who underwent cervical spine surgery in a top three hospital in Beijing from April to December 2018. According to whether to implement enhanced recovery surgery, the patients were divided into enhanced recovery surgery group (eras group) and control group. The self-designed data collection table was used to collect data in the patient's medical records, including general demographic data and disease treatment data, implementation of accelerated rehabilitation surgery and application effect. Among them, the application effect includes the operation related complications, the visual analog scale (VAS) score of neck and shoulder pain, the ability of daily living after discharge, the length of stay, the cost of hospitalization and other recent rehabilitation effect indicators, as well as the rehospitalization rate of 90 days and the Japanese Orthopaedic Society four months after operation Association (JOA) score, neck disability index (NDI) score, neck and shoulder pain symptoms, neck and shoulder stiffness symptoms and other long-term rehabilitation indicators. Independent sample t-test, rank sum test and chi square test were used to compare the differences between the two groups. On the basis of single factor analysis, combined with multi factor analysis, the impact of groups on outcome indicators was clarified, included 90-day readmission, reexamination time, follow-up JOA score, NDI score, neck and shoulder pain symptoms and neck and shoulder stiffness symptoms.

Official Title
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Evaluation of the Effect of Enhanced Recovery After Surgery for Cervical Surgery

Conditions
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Cervical Spondylosis

Intervention / Treatment
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* Procedure: Enhanced recovery after surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ① patients with cervical spondylosis were definitely diagnosed; ② Cervical spine surgery was performed under general anesthesia; ③ Age ≥ 18 years old; Exclusion Criteria: ① patients with cervical deformity correction surgery; ② Patients who underwent secondary cervical spine surgery; ③ Patients with spinal cord injury caused by trauma (4) patients with thoracic and atlantoaxial diseases and corresponding surgery; ⑤ Ankylosing spondylitis patients; ⑥ Patients with cerebral infarction, cerebral palsy and nerve root injury.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| ERAS Group<br>Patients were treated by enhanced recovery after surgery | Procedure: Enhanced recovery after surgery<br>* ERAS management includes 3 parts: (1) Preoperative analgesia and airway evaluation. (2) The protection and reconstruction of the musculo-ligamentous complex during the surgery, the safe intubation, and the local infiltration anesthesia during surgery. (3) Collar free, multimodal analgesia, airway management, and early recovery after surgery.<br>|
| Control Group<br>Patients were not treated by enhanced recovery after surgery | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the ability of daily living | The medical history related to the ability of daily living | Baseline | 
| the ability of daily living | The medical history related to the ability of daily living | 90-day follow-up after surgery | 
| the length of hospital stay | the length of hospital stay | Admission to discharge, an average of 3 days | 
| the cost of hospitalization | the cost of hospitalization | Admission to discharge, an average of 3 days | 
| the rehospitalization rate | the rehospitalization rate of 90 days | 90-day follow-up after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| VAS (visual analog scale ) score | VAS score of neck and shoulder pain, 0-100 points, higher means worse outcomes | Baseline | 
| VAS (visual analog scale ) score | VAS score of neck and shoulder pain, 0-100 points, higher means worse outcomes | 90-day follow-up after surgery | 
| NDI (neck disability index) score | NDI score, 0-100%, higher means worse outcomes | Baseline | 
| NDI (neck disability index) score | NDI score, 0-100%, higher means worse outcomes | 90-day follow-up after surgery | 
| symptoms of neck and shoulder | The presence or absence of neck and shoulder pain symptoms | Baseline | 
| symptoms of neck and shoulder | The presence or absence of neck and shoulder pain symptoms | 90-day follow-up after surgery | 
| symptoms of neck and shoulder | The presence or absence of neck and shoulder stiffness symptoms | Baseline | 
| symptoms of neck and shoulder | The presence or absence of neck and shoulder stiffness symptoms | 90-day follow-up after surgery | 
| neurological function | the Japanese Orthopaedic Society Association (JOA) score, 0-17 points, lower means worse outcomes | Baseline | 
| neurological function | the Japanese Orthopaedic Society Association (JOA) score, 0-17 points, lower means worse outcomes | 90-day follow-up after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Enhanced Recovery after Surgery, Cervical Spondylosis, Outcome measures