Spinal Fusion: Neuromuscular ERAS

Enhanced Recovery After Surgery (ERAS) programs promote an evidence-based, multidisciplinary approach to patient care aimed at facilitating faster recovery from surgery, decreasing hospital length of stay, and minimizing post-operative complications. From scheduling through discharge, all phases of perioperative care are incorporated into ERAS programs.  

Neuromuscular Spinal Fusion ERAS Pathway: 

• NM spinal fusion - assessment/referral Algorithm 
• NM spinal fusion - intraoperative Algorithm 
• NM spinal fusion - PICU Algorithm 
• NM spinal fusion - inpatient Algorithm
• Neuromuscular spinal fusion Synopsis (provides care standards employed for this clinical pathway) 

Additional tools associated with this ERAS Pathway: 

• ERAS overview handout - English 
• ERAS overview handout - Spanish 

 Inclusion and exclusion criteria: 

• Inclusion: 
  • Patients with complex care needs and neuromuscular scoliosis undergoing posterior spinal fusion  
• Exclusion: 
• • Previous index surgery
    • For example, re-operations for previous VEPTR, posterior spinal fusion, growing rod procedure 
  • Pre-existing spinal or hardware infection
  • Trauma/tumor/spondylolisthesis without risk factors 

Committee members involved in the development: 

• Aaron Shaw, DO, FAAOS | Orthopaedic Surgery | Committee Co-Chair 
• Trent Sims, DO, MS | Anesthesiology | Committee Co-Chair
• Michael Benvenuti, MD | Orthopaedic Surgery | Committee Member
• John Anderson, MD | Orthopaedic Surgery | Committee Member 
• Nichole Doyle, MD | Anesthesiology | Committee Member
• Emily Weisberg, MD | Anesthesiology | Committee Member
• Tara Benton, MD, MSCI | Pediatric Critical Care Medicine | Committee Member 
• Cara Holton, MD | Pediatric Critical Care Medicine | Committee Member
• Leah Jones, MD | Hospital Medicine | Committee Member
• Emily Goodwin, MD, FAAP | Beacon Program | Committee Member 
• Samira Naime, MD | Pulmonology | Committee Member
• Aileen Frances Har, MD | Gastroenterology | Committee Member 
• Heather Sambol, RN, APRN | Anesthesiology | Committee Member 
• Anne Stuedemann, MSN, RN, CPNP | Orthopaedic Surgery | Committee Member
• Katie Shedd, MSPAS, PA-C | Orthopaedic Surgery | Committee Member
• Jamie Wilkins, MS, RD, LD, CNSC | Nutrition | Committee Member 

EBP Committee Members: 

• Todd Glenski, MD, MSHA, FASA | Anesthesiology, Evidence Based Practice 
• Andrea Melanson, OTD, OTR/L | Evidence Based Practice 

 Publication dates: 

• Finalized date: 02/2025 
• Next expected revision date: 02/2028 

 Concerns with content: 

If you have any questions regarding this content or identify a broken link, please email evidencebasedpractice@cmh.edu.  

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.