Prospective observational study on the application of an integrative medicine program for the enhanced recovery of patients undergoing spinal surgery: Effects and survey-based analysis

Enhanced recovery after surgery (ERAS) protocols have been widely adopted in various surgical disciplines to accelerate recovery and improve patient outcomes. However, the application of these programs in spinal surgery, particularly with an integrative medicine approach, remains limited. This study aimed to evaluate the effects of a customized integrative medicine-based program on postoperative recovery and to analyze patient-reported preferences for future protocol refinement. This study evaluated the enhanced recovery after spinal surgery (ERAS-K) program in single- and multi-segment spinal fusion surgeries, targeting improved activity as the primary endpoint. Secondary endpoints included pain, digestive dysfunction, and muscle weakness. Patients aged >40 years were divided into ERAS-K and non-ERAS-K groups. Statistical analyses, including ANCOVA and chi-square tests, adjusted for covariates, revealing significant outcomes (P-values adjusted via Benjamini-Hochberg). This study evaluated the ERAS-K program in single- and multi-segment spinal fusion surgeries, with improved activity as the primary endpoint. Secondary endpoints included pain, digestive dysfunction, and muscle weakness. Patients aged >40 years were divided into ERAS-K (N) and non-ERAS-K (M) groups. Postoperative recovery metrics showed no significant differences in numeric rating scale-axial (P = .5588) or numeric rating scale-leg (P = .8576) pain scores at baseline. Postoperatively, axial pain reduction showed a near-significant trend (P = .0525, ANCOVA; ERAS-K: 4.2 ± 1.1, non-ERAS-K: 4.8 ± 1.3). Short form-36 physical (P = .1989; ERAS-K: 42.5 ± 8.2, non-ERAS-K: 41.3 ± 7.9) and mental component scores (P = .9572) were similar. Mean days to improved activity were 4.81 ± 0.9 (ERAS-K) versus 4.96 ± 1.0 (non-ERAS-K; P = .63551). Non-ERAS-K patients preferred physical therapy (P = .053). Outcomes suggest ERAS-K's integrated rehabilitation may reduce the need for standalone physical therapy, though statistical significance was not achieved. Although the ERAS-K program did not demonstrate a statistically significant impact on conventional pain and quality-of-life metrics, this study highlights the critical importance of program standardization in future research. The findings also underscore strong patient-driven demand for the integration of traditional Korean medicine into conventional postoperative care pathways, suggesting that a holistic, patient-centered approach may improve satisfaction and outcomes beyond traditional metrics.