The Holistic Perioperative Management and Recovery Strategies in Lumbar Spine Surgery

A Comprehensive Review

Abstract

Background Standard postoperative care in lumbar spine surgery, historically reliant on isolated surgical intervention and prolonged bed rest, is evolving into a comprehensive, multidisciplinary paradigm. This transition is essential to counter the heightened surgical stress and complication risks observed in an increasingly older patient population presenting with multiple comorbidities.

Aim This comprehensive review evaluates the evidence surrounding holistic perioperative management strategies and assesses their combined efficacy in improving clinical and functional outcomes after lumbosacral procedures.

Material and methods A comprehensive systematic literature search was conducted across major academic databases, limiting inclusion to peer-reviewed, English-language studies focusing on adult degenerative lumbar conditions. Data extraction and qualitative synthesis were performed independently by two reviewers adhering to PRISMA guidelines. 

Results The implementation of unified care protocols—combining resistance-based prehabilitation, standardized ERAS pathways, targeted nutritional supplementation, and early ambulation—significantly mitigates the physiological stress response. Concurrently, addressing psychological factors like kinesiophobia and anxiety through cognitive interventions lowers postoperative opioid dependence, shortens hospital stays, and reduces overall disability.

Conclusions Successful recovery after lumbar spine stabilization relies on a proactive, 

biopsychosocial framework rather than isolated structural correction. Integrating physical, metabolic, and psychological care is key to mitigating patient frailty and securing long-term functional independence.