Efficacy and Safety of Enhanced Recovery After Surgery (ERAS) Protocols for Patients Undergoing Minimally Invasive Transforaminal Lumbar Interbody Fusion Surgery: A Systematic Review and Meta-Analysis.

If you or someone you love has been told they need spinal fusion surgery for a degenerative lumbar condition, you may be wondering how to make recovery as smooth as possible. A new study published in World Neurosurgery looked at a structured approach called Enhanced Recovery After Surgery, or ERAS, applied to a common minimally invasive spine procedure known as MIS-TLIF (minimally invasive transforaminal lumbar interbody fusion).

Researchers analyzed 11 studies comparing patients who followed an ERAS program — which bundles together best practices before, during, and after surgery — versus those who received standard surgical care. The results were encouraging. Patients in the ERAS group left the hospital sooner, experienced less blood loss during surgery, had fewer complications afterward, and reported lower pain scores. They also showed better functional recovery and higher satisfaction with their care.

So what does this have to do with acupuncture? ERAS protocols are specifically designed to be multimodal, meaning they combine several approaches to reduce surgical stress and support healing. Acupuncture is increasingly recognized as a valuable component of these programs, particularly for managing postoperative pain, reducing opioid use, easing anxiety before procedures, and supporting faster recovery of normal body functions like digestion and mobility.

For patients facing spinal surgery, integrating acupuncture into a pre- and post-operative care plan may complement ERAS goals by naturally reducing inflammation, calming the nervous system, and accelerating tissue recovery. While this study did not specifically examine acupuncture, its findings highlight the power of comprehensive, patient-centered care — exactly the kind of holistic approach acupuncture practitioners are trained to provide.

If you are preparing for or recovering from spinal surgery, consider speaking with a licensed, board-certified acupuncturist who has experience in perioperative and pain management care.

This systematic review and meta-analysis (World Neurosurgery) evaluated 11 studies — including randomized controlled trials (RCTs) and cohort studies (CSs) — assessing ERAS protocols versus standard care in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for lumbar degenerative disease. Pooled RCT data demonstrated statistically significant reductions in length of hospital stay, operative time, intraoperative blood loss, postoperative complication rates, VAS pain scores, and Oswestry Disability Index (ODI) scores, alongside improved patient satisfaction (P < 0.05). Cohort study data showed no significant between-group differences in ODI, fusion rate, operative time, or complication incidence, highlighting heterogeneity across study designs. No specific effect sizes were reported in the abstract. Clinical takeaway: ERAS frameworks align closely with integrative perioperative care models. Acupuncturists working in surgical or pain management settings should recognize opportunities to contribute to ERAS teams, particularly in preoperative anxiety reduction, multimodal analgesia, opioid sparing, and accelerated functional rehabilitation post-lumbar surgery.