Enhanced Recovery After Spine Surgery Randomized Clinical Trial

Total opioid use during hospitalization after surgery

Proportion of patients using opioids one month after surgery

• Total morphine equivalents for each post-operative day (POD) 0, 1, 2, 3...21+
• Total morphine equivalents for all post-operative days

• Patient-controlled analgesia (PCA) use (collected mg per hour and morphine equivalent)

• Use of intravenous (IV) narcotics (collected by "Yes" or "No")
• Use of Narcan/Naloxon (collected by "Yes" or "No")

• Number of times opioid was refilled over 1 month

• Medications and number of pills prescribed at discharge

• Number of days until 1st, 2nd, and 3rd refill

• Number of pills leftover at one-month timepoint from surgery

• Compliance with inpatient Enhanced Recovery After Surgery (ERAS) multimodal pain regimen

Total usage of non-opioids medication was collected by mg with the following medications:

• Acetaminophen
• Dexamethasone
• Lidocaine/ Lidoderm
• Toradol
• Valium
• Flexeril
• Gabapentin
• Pregabalin
• Ketamine

Using the Visual Analogue Scale (VAS), patients had to rate their pain on a scale of 1 to 10, with 1 being the least pain and 10 being the least amount of pain. Timepoints included:

• Preop pain score
• Discharge pain score
• Average pain score
• Minimum pain score
• Maximum pain score

• Collection of patient mobilization post-operative day (POD) 0, 1
• Collection of patient ambulation post-operative day (POD) 0, 1

• Record time to mobilization and ambulation

• Collection of total number of inpatient falls

• Collection of patient use of Foley catheter post-operatively

• Collection of patient use for straight catheterization post-operatively

• Collection of patient hospitalization status post-operatively including: inpatient, outpatient and observational

• Total length of stay (days) in hospital
• Total length of stay (days) in intensive care unit (ICU)

• Total length of stay (hours) in hospital
• Total length of stay (hours) in intensive care unit (ICU)

Collection of complications (Yes/No) including:

• Death
• Complications (including surgical site infection, urinary tract infections, cardiopulmonary events, wound dehiscence rates, and non-union rates, and others)
• Morbidities

• Collection of patient re-admission 30-days after surgery
• Collection of patient re-admission 90-days after surgery

• Collection of any reoperations that occurred after the patient's initial surgery

Measured with "Yes" or "No", patients were asked if they completed Enhanced Recovery After Surgery (ERAS) protocols and prior to surgery.

• Collection of discharge disposition following hospital discharge

• Compliance with OR checklist
• Compliance with inpatient ERAS wound care regimen

Using the EQ-5D, data is collected on a scale of 1 to 3 with 1 being no problem, 2 being moderate problem and 3 being severe problem.

Using the EQ-5D, data is collected health scale for today. On a scale 0 to 100 with 100 being the best health and 0 means the worst health.

Using the oswestry low back pain disability index (ODI) scale, patients' responses are calculated on a scale of 0 to 100 with 0 being no pain and 100 being the worst pain.

Using the neck pain disability index (NDI) scale, patients' responses are calculated on a scale of 0 to 100 with 0 being no pain and 100 being the worst pain.

Using the Neurosurgery Patient Satisfaction Outcome questionnaire, patients' satisfaction are recorded with "Yes" or "No" to questions.

Collection of patient working status including:

• currently working
• retired
• disabled
• not working due to a reason other than the condition being treated

• Rate of provider recommendation for additional consultations

• Patient enrollment in service

• ERAP compliance with carbohydrate loading and surgical site preparation

• Pain scores (1 to 10 with 1 being no pain and 10 being worst) at 1, 2, and 3 weeks and at 1, 2, and 3 months postop

• Pain medication use at 1, 2, and 3 weeks and at 1, 2, and 3 months postop
• Patient engagement and likelihood to recommend text messaging service

• Patient engagement and likelihood to recommend text messaging service