Table 1 Basic characteristics of included literatures studies on spine surgery

Adeyemo et al. 2021a [15]

Retrospective

124 patients: -Fast-track group (n = 67, mean age 68.49 ± 8.72, 60% females); −Non-fast-track group (n = 57, mean age 69.7 ± 8.23, 67% females)

Yes

Thoraco-lumbar-pelvic fusion (open approach with posterior osteotomies, and pedicle screw fixation) for adult degenerative scoliosis

> 4

Osteoporosis

1.78 ± 2.85

7 ± 3.88

5.97% urinary retention, 1.49% constipation, 5.97% motor block, 4.48% arrhythmia, 1.49% delirium, 1.49% pneumonia

2.98% 90 days inpatient readmission rate

90 days

↑LOS (7 ± 3.88 vs. 5.82 ± 1.97 days), ↓opioid consumption (248.05 mg vs. 314.05 mg), urinary retention (5.97% vs. 19.3%), constipation (1.49% vs. 31.57%), motor block (5.97% vs. 15.79%), 90 days inpatient readmission rate (2.98% vs. 28.07%) EBL (1284.84 ml vs. 1691.8 ml) in fast-track group vs. non-fast-track group. =operative time, anesthesia duration, ICU LOS, 30 days ER visit rate, other complications

Adeyemo et al. 2021b [16]

Retrospective

83 patients: -Fast-track group (n = 46, mean age 70.22 ± 7.56, 59% females);

-Non-fast-track group (n = 37, mean age 68.47 ± 9.16, 83,8% females)

Yes

Thoraco-lumbar-pelvic fusion (open approach with multiple-level posterior osteotomies, and pedicle screw and rod fixation) for adult degenerative scoliosis

T8-T9, T11

NR

1.96 ± 2.95

5.98 ± 2.65

6.52% urinary retention, 26.09% constipation, 2.17% pruritus, 10.87% cardiac arrhythmia, 2.17% delirium, 4.35% pneumonia, 10.42% motor block

0% 30 days inpatient readmission rate

6 months

↓Urinary retention (6.52% vs. 27.03%), constipation (26.09% vs. 62.16%) in fast-track group vs. non-fast-track group. =LOS, ICU LOS, operative time, anesthesia duration, EBL, 30 day inpatient readmission rate, 30 day ER visit rate, pain score, opioid consumption, ambulation distance, complications (pruritus, cardiac arrhythmia, delirium, pneumonia, motor block)

Angus et al. 2019 [17]

Retrospective

626 patients: -Fats-track group (n = 214, mean age 55.3, 129 females); −Non-fast-track group (n = 412, mean age 50.5, 135 females)

Yes

Elective surgery, PLIF (with/without bone grafting) for adult complex degenerative spinal deformity or multilevel adolescent scoliosis correction

> 1

NR

NR

5.2 and 8 days

NR

1.9% 30 days readmissions

2 years

↑Patient satisfaction (100% vs. 84%) and ↓LOS (5.2 vs. 7 days for complex fixation, and 8 vs. 11 days for degenerative scoliosis correction), complications, 30 days readmissions (1.9% vs. 2.1%) in fast-track group vs. non-fast-track group. =levels fused

Brusko et al. 2019 [18]

Retrospective

97 adult patients: -Fast-track group (n = 57, mean age 65.5 ± 9.3, 24 females); −Non-fast-track group (n = 40, mean age 68.1 ± 9.9, 20 females)

Yes

Elective, posterior lumbar fusion (open procedures and MIS with percutaneous pedicle screws)

1- to 3

NR

NR

2.9 ± 1.9 days

NR

NR

6 months

↓LOS (2.9 ± 1.9 vs. 3.8 ± 1.8 days), pain (at day 1, 4.2 ± 3.2 vs. 6.0 ± 3.2), oxycodone-acetaminophen consumption (at day 0, 408.0 ± 527.2 vs. 1094.7 ± 847.6 mg; at day 1, 1320.0 ± 1026.4 vs. 1708.4 ± 819.6 mg; at day 3, 1500.1 ± 778.5 mg vs. 2105.4 ± 1090.6 mg; during LOS, 2729.5 ± 4594.3 mg vs. 5230.3 ± 3920.3 mg), meperidine consumption (8.8 ± 32.9 vs. 44.7 ± 87.5 mg), IV pain medication (1.6 ± 1.2 vs. 2.0 ± 1.1 days), ondansetron consumption (2.81 ± 4.3 vs. 6.0 ± 10.5 mg) and ↑levels fused (92 vs. 62), hydromorphone consumption, distance ambulated (at day 1, 109.4 ± 130.4 vs. 41.4 ± 62.0 ft) in fast-track group vs. non-fast-track group

Carr et al. 2019 [19]

Retrospective

932 patients: -Fast-track group (n = 620, mean age 60 ± 13, 322 females); −Traditional care group (n = 183, mean age 61 ± 14, 103 females);

-No pathway care group (n = 129, mean age 58 ± 13, 72 females)

Yes

Elective spine surgery (arthrodesis with instrumentation anterior > 2 levels or posterior > 3 levels, corpectomy in cervical, thoracic, or lumbar region, pelvic fixation) for adult spinal deformity

≥4 (nonrevision surgery), ≥3 (revision surgery)

Poor functional status, daily home oxygen, CPAP/BiPAP, unstable angina, pacemaker, automatic implantable cardiac defibrillator or ventricular assist device, pulmonary hypertension, diabetes with Hb A1c > 8%, hypertension or arrhythmias, coagulation disorders or patients receiving anticoagulants and antiplatelets

1.8 days

5.4 days

NR

NR

NR

↑Operative time in traditional care group vs. fast-track group and no pathway care group, and = between fast-track group and no pathway care group. ↓LOS (5.4 vs. 8.2 and 8.0 days), ICU LOS (1.8 vs. 3.1 and 2.5 days), costs (by 29 and 11%) in fast-track group vs. traditional care group and no pathway care group

Chang et al. 2020 [20]

Retrospective

48 patients: -Fast-track group (n = 24, mean age 64.3 ± 11.59, 10 females); −Non-fast-track group (n = 24, mean age 60.1 ± 12.23, 13 females)

Yes

TLIF (mesh expandable cage, percutaneous pedicle screw placement and rod fixation, off-label use recombinant human BMP-2) for adult degenerative lumbar spine disease

L1–2, L2–3, L3–4, L4–5, L5–S1

Obesity and sarcopenia

NR

1.4 ± 1.13 days

1 infection at the interbody space (2 months after surgery)

NR

3, 6 and 12 months

↑Postoperative ODI, discharge at day 1 (79%) and ↓LOS (1.4 ± 1.13 vs. 4.0 ± 1.98 days), operation time (110.7 ± 21.23 vs. 154.8 ± 39.53 min), EBL (66.0 ± 37.24 vs. 121.4 ± 62.39 ml), oral and IV opioid consumption (22.8 ± 20.20 mg on day 0 and 21.6 ± 18.72 mg on day 1 vs. 38.1 ± 23.27 mg on day 0 and 44.3 ± 23.10 mg on day 1) in fast-track group vs. non-fast-track group

Chen et al. 2021 [21]

Retrospective

78 patients: -Fast-track OLIF group (n = 38, mean age 61.84 ± 6.20, 44.7% females); −Fast-track TLIF group (n = 40, mean age 61.15 ± 5.52, 42.5% females)

No

OLIF (with pedicle screw-rod internal fixation, interstitial approach) and single-level instrumented TLIF (with polyaxial pedicle screws and crescent-shaped interbody cage) for adult lumbar degenerative diseases (disc herniation, spinal stenosis, degenerative slippage I-II degrees, spondylolysis)

L4/L5

Hypertension or diabetes

NR

7.87 ± 1.04 days

NR

NR

6 and 12 months

↓EBL (59.53 ± 11.80 vs. 102.48 ± 14.22 ml), LOS (7.87 ± 1.04 vs. 9.23 ± 0.95 days) in OLIF group vs. TLIF group. =operative time, overall satisfaction. ↓red blood count, albumin, VAS score, ODI, and ↑CRP, D-dimer, JOA in postoperative vs. preoperative

Dagal et al. 2019 [22]

Retrospective

450 adult patients: -Fast-track group (n = 267, mean age 60 ± 12, 55.4% females);

-Non-fast-track group (n = 183, mean age 61 ± 14, 56.2% females)

Yes

Major elective spine surgery, cervico-thoracic, thoracolumbar levels

NR

Anemia, dementia, depression, diabetes, hypertension, coronary artery disease, congestive heart failure, chronic kidney disease, chronic pulmonary disease, cerebrovascular accident, chronic opioid use (substance abuse), obstructive sleep apnea

1.4 days

3.6 days

1.1% pneumonia, 1.1% pulmonary embolism, 0.7% sepsis, 1.5% surgical site bleeding, 8.2% wound infection, 0.4% death

9.7% 30 days readmissions

30 days

↓LOS (3.6 vs. 6.3 days), ICU LOS (1.4 vs. 4.7 days), costs ($62.429 to $53.355), EBL (711 vs. 1066 ml), postoperative ICU admissions (48% vs. 60%) in fast-track vs. non-fast-track group. =anesthesia duration, complications, 30 days readmission

d’Astorg et al. 2020 [23]

Retrospective

386 patients: -Fast-track group (n = 193, mean age 46 ± 12); −Non-fast-track group (n = 193, mean age 46 ± 13)

Yes

Microdiscectomy and arthrodesis (1 or 2-level retroperitoneal ALIF, 1 to 3-level circumferential fusion with combined approach ALIF + posterior instrumentation, 1 to 3-level posterior fusion, anterior cervical fusion) for adult spinal deformities (herniated lumbar disc, single or multilevel lumbar stenosis)

1 to 3

NR

NR

2.6 days

1 cervicalgia after load carrying 3 weeks after cervical fusion, 1 suspicion of pulmonary embolism, 1 malaise following intolerance to tramadol (3 visits to A&E department)

1 readmission (cleaning of the surgical scar)

1 year (arthrodesis) and 3 months (microdiscectomy)

↑Satisfaction and ↓LOS (2.6 vs. 4.4 days), pain VAS, ODI score in fast-track group vs. non-fast-track group. =complications, readmission

Debono et al. 2019 [24]

Retrospective

3483 patients: -Fast-track group (n = 1920: 202 ALIF, mean age 46.3 ± 10.7, 49% females; 612 ACDF, mean age 48.7 ± 8.7, 49% females; 1106 posterior fusion, mean age 56.1 ± 10.2, 50.9% females); −Non-fast-track group (n = 1563: 159 ALIF, mean age 44.5 ± 8.6, 56.6% females; 749 ACDF, mean age 47.6 ± 9.9, 45.6% females; 655 posterior fusion, mean age 53.8 ± 14.3, 49.7% females)

Yes

Elective spine surgery (retroperitoneal ALIF, ACDF with anterior approach, posterior or posterolateral fusion as PLIF and TLIF, with PEEK cages or plates) for adult degenerative conditions

NR

NR

NR

3.33 ± 0.8 days (ALIF), 1.3 ± 0.7 days (ACDF), 4.8 ± 2.3 days (posterior fusion)

11.4% for ALIF (medical 3.5%, wound 3.5%, neurological 1.5%, implants 1.0%, urinary tract infection 2.0%), 8.2% for ACDF (medical 2.1%, cervical approach 2.8%, implants 2.8%, infection 0.5%), 10.9% for posterior fusion (medical 2.6%, wound 2.5%, neurological 1.4%, dural leakage 1.7%, implants 2.0%, urinary tract infection 0.6%)

3.0% 90 days rehospitalization and 1.5% revision surgery for ALIF, 1.5% 90 days rehospitalization and 0.8% revision surgery for ACDF, 6.1% 90 days rehospitalization and 3.7% revision surgery for lumbar fusions

90 days

↓LOS (3.33 ± 0.8 vs. 6.06 ± 1.1 days for ALIF, 1.3 ± 0.7 vs. 3.08 ± 0.9 for ACDF, 4.8 ± 2.3 vs. 6.7 ± 4.8 for posterior fusion) in fast-track group vs. non-fast-track group. =complications, 90 days rehospitalization rate or revision rate for ALIF and ACDF. =90 days rehospitalization rate for posterior fusion. ↓complications (10.9% vs. 14.8%), surgical revision rate (3.7% vs. 6.1%) for lumbar fusions

Debono et al. 2021 [25]

Retrospective

404 patients: -Fast-track group (n = 202, mean age 48.5 ± 10.6, 49% females); −Non-fast-track group (n = 202, mean age 48.7 ± 9.2, 47.5% females)

Yes

ACDF (anterior approach, PEEK cages alone or with plates) for adult radiculopathy with disc prolapse either hard (osteophytic) or soft

NR

NR

NR

1.40 ± 0.6 days

6.9% overall complications, 3.5% major complications (new neurological deficit 2.5%, neck hematoma 1.0%), 3.5% minor complications (dysphagia/dysphonia 2.5%, hardware failure 0.5%, surgical site infection 0.5%)

0% 30 days readmission, 0% 30- to 90 days readmission, 1.0% 90 days reoperation

30 and 90 days, 12 months

↓LOS (1.40 ± 0.6 vs. 2.96 ± 1.35 days) in fast-track group vs. non-fast-track group. =satisfaction, complications (overall, major, minor), 30 days readmission, 30- to 90 days readmission, 90 days reoperation

DeVries et al. 2020 [26]

Retrospective

244 patients: -Fast-track group (n = 131, mean age 15.3 ± 1.9, 78.6% females); −Non-fast-track group (n = 113, mean age 15.2 ± 2.0, 77.0% females)

Yes

PIF for AIS

NR

NR

NR

3.4 days

50% (2/4) wound complications (surgical site drainage), 50% (2/4) wound dehiscence

66.6% (2/3) screw misplacement and/or removal, 33.3% (1/3) deep wound infection requiring irrigation and debridement, 40.0% (4/10) constipation, 20.0% (2/10) syncope, 10.0% (1/10) pain, 30.0% (3/10) other

30 days

↓LOS (3.4 vs. 5.2 days), patient-controlled analgesia discontinuation (51.7 vs. 62.0 h), catheter discontinuation (1.9 ± 0.3 vs. 2.4 ± 0.6 days), standing initiated (1.0 ± 0.09 vs. 1.9 ± 0.6 days), walking initiated (1.9 ± 0.3 vs. 3.0 ± 0.9 days), and ↑curve magnitude (67.5 ± 13.3° vs. 62.3 ± 10.8°), curve correction (45.8 ± 13.8° vs. 38.2 ± 12.1°) in fast-track group vs. non-fast-track group. =complications, 30 days readmission, 30 days reoperation, 30 days visit, EBL

Duojun et al. 2021 [27]

Retrospective

120 patients: -Fast-track group (n = 60, mean age 47.92 ± 5.89, 28 females); −Non-fast-track group (n = 60, mean age 48.60 ± 5.80, 31 females)

Yes

PETD for adult single-level LDH

L4/5

Obesity or intervertebral foraminal stenosis

NR

3.47 ± 1.14 days

1 nerve damage, 1 incision infection, 2 lumbar and leg pain, 1 respiratory infection, 1 gastrointestinal reactions

NR

NR

↓LOS (3.47 ± 1.14 vs. 5.65 ± 1.39 days), VAS pain score (2.25 ± 0.82 vs. 3.33 ± 0.60 at day 1, 1.87 ± 0.50 vs. 3.07 ± 0.66 at day 2, 1.47 ± 0.54 vs. 2.25 ± 0.47 at day 3) in fast-track group vs. non-fast-track group. =complications, ODI, operative time, costs

Feng et al. 2019 [28]

Retrospective

74 patients: -Fast-track group (n = 44, mean age 61 ± 10, 63.6% females); −Non-fast-track group (n = 30, mean age 59 ± 9, 70% females)

Yes

MIS-TLIF (ipsilateral side facetectomy, and interbody fusion with unilateral access, bilateral MIS decompression with unilateral approach, pedicle screws percutaneous via bilateral approaches) for adult lumbar spinal stenosis, spondylolisthesis, degenerative lumbosacral spine diseases, radiculopathy, or neurogenic claudication

L3–4, L4–5, L5-S1

Diabetes mellitus, chronic cardiovascular disease

NR

5 days

4.5% (1 cage migration without symptoms, 1 epidural hematoma with radiculopathy)

0 30 days readmission, 1 30 days reoperation

30 days

↓LOS (5 vs. 7 days), costs, EBL (100 vs. 150 ml), operative time (206 vs. 228 min), IV fluid volume (1625 vs. 1827 ml), drainage at day 1–3 (85.5 vs. 160 mL) in fast-track group vs. non-fast-track group. =complications, 30 days readmission and reoperation rates

Flanders et al. 2020 [29]

Retrospective

1290 adult patients: -Fast-track group (n = 1141, mean age 61.5 ± 13.4, 533 females); −Non-fast-track group (n = 149, mean age 61.9 ± 12.1, 72 females)

Yes

Elective spine and peripheral nerve surgeries (cervical/thoracic/lumbar laminectomy and/or instrumented fusion, anterior cervical discectomy and fusion, combined anterior/posterior surgeries, and peripheral nerve procedures, brachial plexus surgery, ulnar and median nerve decompression, and common peroneal nerve surgery)

1–3

Chronic obstructive pulmonary disease, obstructive sleep apnea

44.9%

3.4 days

17.7%

6.4% 30 days readmission, 7.4% 90 days readmission

1, 3, 6 and 18 months

↓Opioids use (38.6% vs. 70.5% at 1 month, 36.5% vs. 70.9% at 3 months, 23.6% vs. 51.9% at 6 months), patient-controlled analgesia use (1.4% vs. 61.6%), LOS (3.4 vs. 3.9 days), ICU admissions (44.9% vs. 78.9%), likely to have an indwelling catheter while recovering in the inpatient ward (23.0% vs. 55.1%), nonopioid and ↑mobility at day 0 (63.5% vs. 20.7%), ambulation at day 0 (41.8% vs. 17.2%) in fast-track group vs. non-fast-track group. =satisfaction, complications, readmissions within 30 or 90 days

Fletcher et al. 2020 [30]

Retrospective

197 patients (13.2 ± 3.2 age, 110 females, 87 males): -Fast-track + LOS < 3 days group (n = 56); −Fast-track + LOS 3–7 days group (n = 1111); −Fast-track + LOS > 7 days group (n = 30)

No

PSF for NMS

1–3, 4–5

NR

1.0, 3.1, 5.6 days

3.6 h

Pulmonary (1.8, 14, 40%), neurologic deficits (2, 4, 7%), infection (2, 1, 9%), decubitus ulcers (0, 1, 4%), cut out/loosening/implant malplacement (0, 2, 0%)

Readmission (9, 17, 27%)

180 days

↓Fusion to pelvis (38% vs. 71 and 73%), levels fused (12.9 vs. 15.1 and 15.3), LOS (3.6 vs. 4.5 and 5.1 h), pulmonary complication (1.8% vs. 14 and 40%) in LOS < 3 days group vs. LOS 3–7 days and LOS > 7 days groups. =readmission, EBL, transfusion, complications, time ICU, required ICU

Fletcher et al. 2021 [31]

Prospective

276 patients: -Fast-track group (n = 203, mean age 14.3 ± 2.1, 78.8% females); −Non-fast-track group (n = 73, mean age 16.09 ± 2.1, 80.2% females)

Yes

PSF for AIS

NR

NR

NR

2.2 days

2 wound dehiscence, 1 constipation

Readmission, revision surgery

3–4 weeks

↓Major curve (54.0° vs. 62.0°), major curve correction (39.0° vs. 45.5°), LOS (2.2 vs. 4.8 days), operative time (2.8 vs. 4.8 h), EBL (240.0 vs. 500.0 ml), EBL/level (24.0 vs. 47.2 ml), EBL (6.4 vs. 13.3%EBV), levels fused (10.1 ± 2.6 vs. 11.4 ± 1.6), implant density (16.0 vs. 23.0), VAS at discharge (2.0 vs. 4.0), osteotomies (46% vs. 94%) in fast-track group vs. non-fast-track group

Garg et al. 2021 [32]

Retrospective

812 patients: -Fast-track group (n = 316, mean age 49.1 ± 11.7, 45% females); −Non-fast-track group (n = 496, mean age 50.3 ± 12.4, 46,8% females)

Yes

Elective lumbar spinal fusion at 1, 2, or 3 levels with posterior approach (TLIF with open or MIS techniques) for various adult lumbar spinal disorders (lumbar disc herniation, low-grade spondylolisthesis, lumbar canal stenosis, degenerative disc disease, facet joint cyst)

1–3

Secondary osteoporosis, diabetes

NR

2.94 days

Complications Clavien-Dindo grade (6.6% grade I, 3.2% grade II, 1.9% grade III)

2.2% 60 days readmission, 1.3% 60 days reoperation

4 weeks, 6 and 12 months

↓LOS (2.94 vs. 3.68 days), VAS score at 1 month (44 ± 10.8 vs. 49.8 ± 12.0), ODI score at 1 month (28 ± 12.8 vs. 31.6 ± 14.2) in fast-track group vs. non-fast-track group. =levels fused, EBL, operative time, complications, 60-day readmission, 60-day reoperation

Gong et al. 2021 [33]

Retrospective

91 patients: -Fast-track group (n = 46, mean age 55.2 ± 10.8, 30 females); −Non-fast-track group (n = 45, mean age 56.8 ± 8.9, 26 females)

Yes

PELIF for adult degenerative disc disease (degenerative spondylolisthesis, lumbar spinal canal stenosis, segmental instability, recurrent lumbar disc herniation, lumbar discogenic pain, isthmic spondylolisthesis)

1 or 2

Hypertension, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease, asthma, liver disease

NR

3.1 ± 0.7 days

2

0 readmission

30 days

↓Opioid consumption (25.0 vs. 33.3), VAS score at day 1 (2.0 ± 0.6 vs. 2.6 ± 0.7) in fast-track group vs. non-fast-track group. =operative time, EBL, surgical dram drainage, LOS, cost, complication, 30 days readmission

He et al. 2020 [34]

Prospective

40 patients: -Fast-track + TXA group (n = 20, mean age 57.95 ± 12.44, 60% females); −Non-fast-track group (n = 20, mean age 57.9 ± 11.76, 45% females)

Yes

TLIF surgery (with pedicle screws, rods and cage filled with autogenous bone graft) for adult lumbar disc herniation, stenosis, or spondylolisthesis with unilateral radiculopathy

1 or 2

NR

NR

5.5 ± 2.0 days

1 superficial wound infection, 1 hypoproteinemia, 3 liver dysfunctions

NR

NR

↓EBL (91.50 ± 37.31 vs. 145 ± 108.7 ml), time to ambulation in fast-track group vs. non-fast-track group. =LOS, operative time, drainage, time for drainage removal, complications, Hb at day 1

Heo et al. 2019 [35]

Retrospective

69 patients: -Fast-track group (endoscopic TLIF, n = 23, mean age 61.4 ± 9.4, 69.6% females); −Non-fast-track group66 (microscopic TLIF, n = 46, mean age 63.5 ± 10.5, 58.6% females)

Yes

MIS-TLIF (with percutaneous biportal endoscopic approach and percutaneous pedicle screw insertion, cages and local autologous bone chips) for adult low-grade degenerative spondylolisthesis (grade 1), low-grade isthmic spondylolisthesis (grade 1), central stenosis with instability, and central stenosis with concomitant foraminal stenosis

L3–4, L4–5, L5-S1

NR

NR

NR

1 symptomatic epidural hematoma, 1 cage subsidence

0 readmission

Mean 13.4 ± 2.5 months

↓VAS score for preoperative back pain on day 1 and 2 (4.2 ± 1.0 vs. 4.9 ± 1.3 and 2.8 ± 0.5 vs. 4.2 ± 0.8), EBL (190.3 ± 31.0 vs. 289.3 ± 58.5 ml) and ↑operative time (152.4 ± 9.6122.4 ± 13.1 ml) in fast-track group vs. non-fast-track group. =VAS back and leg pain scores and ODI at final follow-up, complications and readmission rates, fusion rate

Ifrach et al. 2020 [36]

Prospective

564 adult patients: -Fast-track group (n = 504, mean age 73.2, 47% females); −Non-fast-track group (n = 60, mean age 73.5, 53.3% females)

Yes

Elective spine and peripheral nerve surgery (cervical/thoracic/lumbar laminectomy and/or instrumented fusion, ACDF, combined anterior-posterior surgeries, peripheral nerve procedures, brachial plexus surgery, ulnar and radial nerve decompression, carpal tunnel release, and common peroneal nerve surgery)

0–3 or 4+

Diabetes, hypertension, chronic obstructive pulmonary disease, mental health disorders, and substance abuse disorders, sleep apnea

NR

3.7 days

NR

NR

1 and 3 months

↓Opioid consumption (36.2% vs. 71.7% at 1 month, 33.0% vs. 80.0% at 3 months), patient-controlled analgesia (0.8% vs. 58.9%), catheters use (26.6% vs. 60.3%), LOS (3.7 vs. 4.3 days), pain and ↑mobilization at day 0 (60.0% vs. 10.0%), ambulation at day 0 (36.1% vs. 10.0%) in fast-track group vs. non-fast-track group. =mobilization and ambulation at day 1

Jazini et al. 2021 [37]

Retrospective

290 patients: -Fast-track group (n = 116, mean age 54.63 ± 13.05, 50% females); −Non-fast-track group (n = 174, mean age 54.56 ± 15.31, 52% females)

Yes

Lumbar fusion surgery ALIF and PIF for degenerative conditions

< 4

Stroke, DVT

NR

3.69 days

NR

NR

90 days

↓Pain scores at 3 months (2.89 vs. 3.57), in-hospital opioid consumption (374.43 vs. 781.25 MMEs), and ↑day ambulated (0.39 vs. 0.84), day catheter removed (1.14 vs. 1.44) in fast-track group vs. non-fast-track group. =90-day opioid consumption, EBL, operative time, LOS

Julien-Marsollier et al. 2020 [38]

Retrospective

163 patients (< 18 age): -Fast-track group (n = 81, mean age 15 ± 2, 81.5% females); −Non-fast-track group (n = 82, mean age 15.3 ± 1.8, 82.9% females)

Yes

Posterior fusion for AIS

NR

NR

NR

4 days

Opioid side effects (56.8% constipation, PONV), pain intensity, wound infection

NR

30 days

↓LOS (4 vs. 7 days), morphine consumption (25 and 35% at days 2 and 3), constipation at day 3 (56.8% vs. 73.2%), pain intensity at rest and movement at days 2 and 3 in fast-track group vs. non-fast-track group. =morphine consumption at day 1, PONV, wound infection

Kalinin et al. 2021 [39]

Prospective

53 patients: -Fast-track group (n = 24, mean age 58, 10 females); −Non-fast-track group (n = 29, mean age 55, 11 females)

Yes

Two-level transforaminal interbody fusion (dorsal decompression and stabilization surgeries) for polysegmental degenerative diseases of the lumbar spine (lower back pain and radicular clinical symptoms, involvement of two adjacent vertebral segments, and absence of improvement after conservative treatment for 6–8 weeks)

L2, L3, L4, L5, L6, S1

Diabetes, arterial hypertension, kidney diseases, lung diseases, coronary artery disease

NR

NR

1 bradycardia, 1 dizziness, 1 nausea, 1 venous thromboembolic complication, pseudoarthrosis

No re-hospitalization

18 months

↓Operative time (168 vs. 256 min), anesthesia time (185 vs. 270 min), EBL (75 vs. 180 ml), agents administered for anesthesia-0.005% fentanyl (20.0 vs. 31 ml), verticalization time (1 vs. 2 days), duration of inpatient treatment (9 vs. 10 days), pain, complication, ICU and ↑quality of life indicators, physical and psychological components of health in fast-track group vs. non-fast-track group

Kerolus et al. 2021 [40]

Retrospective

299 patients: -Fast-track group (n = 87, mean age 62.44 ± 11.66, 51 females); −Non-fast-track group (n = 212, mean age 60.17 ± 13.21, 116 females)

Yes

Elective single-level MIS-TLIF (with bilateral pedicle screw fixation) for degenerative disease

NR

NR

NR

3.13 ± 1.53 days

12.6% delirium, 48.3% urinary retention

0 90 days reoperation, 5.7% 30 days readmission

20 months

↓LOS (3.13 ± 1.53 vs. 3.71 ± 2.07 days), total daily average MME (50.55 ± 63.48 vs. 91.18 ± 99.76 MME), total admission MME (252.74 ± 317.38 vs. 455.91 ± 498.78), opioid consumption at day 1 (72.79 ± 70.52 vs. 177.60 ± 134.69 MME), at day 4 and onwards (21.37 ± 54.93 vs. 73.67 ± 262.34 MME), patient-controlled analgesia (29.9% vs. 86.8%), catheterization (48.3% vs. 65.6%) in fast-track group vs. non-fast-track group. =pain, opioid consumption at day 0, non-patient-controlled analgesia IV and oral opioids, delirium, operative time, 30 days readmission, 90 days reoperation

Kilic et al. 2019 [41]

Retrospective

120 patients: -Fast-track group (n = 60, mean age 50.43 ± 6.84, 30 females); −Non-fast-track group (n = 60, mean age 49.80 ± 6.04, 35 females)

Yes

Single-level lumbar microdiscectomy

NR

NR

NR

26.52 ± 5.16 h

NR

NR

NR

↓Operative time (78.50 ± 25.20 vs. 86.42 ± 18.39 min), EBL (93.17 ± 48.89 vs. 187.67 ± 47.37 ml), opioid administration (50 vs. 147.92 ± 22.69 μg), fluid administration (665.0 ± 233.49 vs. 2044.1 ± 401.38 ml), time to oral intake (2.88 ± 0.92 vs. 4.90 ± 1.08 h), time to mobilization (4.10 ± 0.95 vs. 7.20 ± 2.33 h), PONV (15.0% vs. 63.3%), analgesic required (13.3% vs. 100%), LOS (26.52 ± 5.16 vs. 30.10 ± 7.80 h), anesthesia cost (73.00 ± 24.93 vs. 270.42 ± 87.16TL), operation cost (1258.67 ± 39.89 vs. 1991.67 ± 67.12TL), VAS scores at 6 h (1.68 ± 1.40 vs. 4.03 ± 0.88) and at 12 h (1.12 ± 0.80 vs. 3.08 ± 0.90) in fast-track group vs. non-fast-track group

Kilic et al. 2020 [42]

Retrospective

174 patients: -Fast-track group (n = 86, mean age 54.79 ± 13.73, 53.4% females); −Non-fast-track group (n = 88, mean age 49.77 ± 16.96, 53.4% females)

Yes

Elective lumbar spine instrumentations for idiopathic lumbar scoliosis, degenerative spondylolisthesis, spinal canal stenosis

NR

Chronic cardiovascular disease, chronic pulmonary disease, diabetes mellitus

NR

31.24 ± 4.87 h

11.6% complications

1.48 ± 0.85 30 days readmission

30 days

↓EBL (204.42 ± 124.40 vs. 414.26 ± 237.64 ml), transfusion (1.08 ± 0.29 vs. 2.00 ± 0.92unit), first oral intake (4.34 ± 0.85 vs. 8.82 ± 3.41 h), first mobilization (13.80 ± 1.41 vs. 25.40 ± 3.13 h), LOS (31.24 ± 4.87 vs. 49.52 ± 5.96 h), pain scores at 12 h (1.84 ± 0.96 vs. 4.65 ± 1.41) and at 24 h (1.74 ± 0.81 vs. 4.48 ± 1.31), anesthesia cost (232.32 ± 19.44 vs. 533.86 ± 19.56TL), ICU cost (3726.51 ± 934.70 vs. 4994.09 ± 847.31TL), laboratory cost (279.30 ± 16.43 vs. 383.64 ± 18.39TL), radiology cost (271.98 ± 13.36 vs. 407.16 ± 49.31 TL) in fast-track group vs. non-fast-track group. =operative time, 30 days readmission, complication, surgery cost

Kim et al. 2021 [43]

Retrospective

40 patients: -Fast-track group (n = 20, mean age 65.7 ± 8.1, 65.0% females); −Non-fast-track group (n = 20, mean age 66.7 ± 9.6, 80% females)

Yes

≥5 levels of fusion to the pelvis with pedicle screws, rods, bone grafting for thoracolumbar adult deformity

L2-L5

Diabetes, osteoporosis, depression, hypertension, chronic pulmonary disease, chronic kidney disease

NR

4.5 ± 1.3 day

10% (2 dural tears)

20% (1 revision for a proximal junctional failure, 2 revisions for traumatic L5 pedicle fracture and proximal junctional failure)

90 days

↓EBL (920 ± 640 vs. 1437 ± 555 ml), ICU (0% vs. 30%), LOS (4.5 ± 1.3 vs. 7.3 ± 4.4 days), operative time (4.1 ± 1.2 vs. 5.0 ± 1.1 h), and ↑ambulation at day 1 (100% vs. 55%), EBL < 1200 mL (75% vs. 45%), procedure length < 4.5 h (66.7% vs. 33.3%) in fast-track group vs. non-fast-track group. =90 days readmission, complications, transfusion, discharge, drain and catheter discontinuation, levels fused

Lampilas et al. 2021 [44]

Retrospective

88 patients: -Fast-track group (n = 44, mean age 55.1 ± 15.8, 50% females); −Non-fast-track group (n = 44, mean age 55 ± 17.9, 38% females)

Yes

ALIF, ACF, lumbar release, LDH, cervical laminectomy

NR

NR

NR

3.3 ± 0.9 days

6 early unscheduled consultations (5 for pain, and 1 for postoperative neurologic deficit)

4.5% 90 days readmission (1 for pain resistant to home analgesia, 1 for cerebrospinal fluid leakage)

6 months

↓LOS (3.3 ± 0.9 vs. 6 ± 2.9 days), admission costs (5415 ± 1714 vs. 6302 ± 2303€) in fast-track group vs. non-fast-track group. =complications, 90 days readmission, total costs

Li et al. 2018 [45]

Retrospective

224 patients: -Fast-track group (n = 114, mean age 58.53 ± 10.71, 42.1% females); −Non-fast-track group (n = 110, mean age 56.88 ± 8.82, 39% females)

Yes

Cervical laminoplasty for degenerative multilevel spine compression, spinal canal stenosis

C3-C7

Diabetes mellitus, cardiovascular disease

NR

5.75 ± 2.46 days

3.51% C5 palsy, 4.39% incisional infection, 8.77% nausea and vomiting, 0.88% pulmonary infection, 1.75% urinary infection, 0.88% neurological deterioration, 0.88% epidural hematoma

NR

3 days

↓LOS (5.75 ± 2.46 vs. 7.67 ± 3.45 days), first assisted walking time (30.79 ± 14.45 vs. 65.24 ± 25.34), drains removal time (43.92 ± 7.14 vs. 48.85 ± 10.10 h), catheters removal time (24.76 ± 12.34 vs. 53.61 ± 18.16 h), first eating time (8.45 ± 2.94 vs. 21.64 ± 2.66 h), mean VAS score (2.72 ± 0.46 vs. 3.35 ± 0.46), maximum VAS score (3.76 ± 1.12 vs. 4.35 ± 1.15) in fast-track group vs. non-fat-track group. =operative time, EBL, first defecation time, complications, outbreak pain (VAS ≥ 5)

Li et al. 2020 [46]

Retrospective

Fast-track group, 260 patients: -Higher compliance group (n = 91, mean age 69.6 ± 4.4, 51 females); −Lower compliance group (n = 169, mean age 73.3 ± 7.1, 97 females)

No

Open posterior lumbar fusion surgery for lumbar stenosis with instability, scoliosis/ spondylolisthesis

1–2 or > 3

Hypertension, diabetes, ischemic heart disease, arrhythmias, gastrointestinal, chronic lung disease, Parkinson disease, depression

NR

11.8 ± 4.5 and 14.6 ± 6.1 days

40 complications (13 surgical site infection, 3 neurological deficit, 4 electrolyte abnormality, 4 pneumonia, 1 DVT/thrombophlebitis, 1 pulmonary embolism, 3 myocardial infarction, 2 urinary tract infection, 1 stroke, 1 sepsis, 7 delirium)

2 30 days readmission (surgical site infection), no re-operation or death

30 days

↓LOS (11.8 ± 4.5 vs. 14.6 ± 6.1 days), complications (8 vs. 32) in higher compliance group vs. lower compliance. =operative time, EBL, 30 days readmission

Li et al. 2021 [47]

Retrospective

127 patients: -Fast-track group (n = 60, mean age 73.6 ± 3.2, 63.3% females); −Non-fast-track (n = 67, mean age 74.3 ± 4.2, 59.7% females)

Yes

Open lumbar arthrodesis for lumbar stenosis

1–2 or > 3

Hypertension, diabetes, ischemic heart disease, arrhythmias, gastrointestinal, chronic lung disease, Parkinson disease, depression

NR

13.6 ± 4.0 days

8.3% complications (5: 2 surgical site infection, 1 electrolyte abnormality, 1 arrhythmia, 1 cerebrospinal fluid leakage)

NR

30 days

↓LOS (13.6 ± 4.0 vs. 15.6 ± 3.9 days), complications (8.3% vs. 20.9%), and ↑early ambulation (70.0% vs. 7.5%), early oral feeding (86.7% vs. 3.0%), early removal of catheter (80.0% vs. 14.9%), nutritional intervention (45.0% vs. 19.4%), VAS back at day 1 (3.8 ± 1.7 vs. 5.7 ± 2.3) and at day 2 (3.6 ± 1.9 vs. 4.5 ± 2.2) in fast-track group vs. non-fast-track group. =operative time, EBL

Nazarenko et al. 2016 [48]

Prospective

48 patients: -Fast-track group (n = 23, mean age 44.3, 39.1% females); −Non-fast-track group (n = 25, mean age 42.2, 44% females)

Yes

Microdiscectomy for lumbosacral spine herniated intervertebral discs

L1-L2, L3-L4, L4-L5, L5-S1

NR

NR

2.3 days

1 poor healing of wound

NR

1, 3 and 6 months

↓VAS pain at discharge (2.8 vs. 3.8) and at 1 month (1.7 vs. 2.6), ODI at discharge (11 vs. 19) and at 1 month (8 vs. 17), Roland-Morris scale at discharged (9 vs. 13) and at 1 month (8 vs. 11), LOS (2.3 vs. 3.8 days), and ↑satisfaction in fast-track group vs. non-fast-track group. =operative time, EBL

Rao et al. 2021 [49]

Retrospective

117 patients: -Fast-track group (n = 39, mean age 15.0 ± 2.4, 87.2% females); −Non-fast-track group (n = 78, mean age 14.3 ± 1.9, 83.3% females)

Yes

PSF for AIS

NR

NR

NR

3.8 ± 0.9 days

NR

0 readmission

NR

↓LOS (3.8 ± 0.9 vs. 4.6 ± 0.9 days), epidural h (11.8% vs. 16.0%), patient-controlled analgesia discontinuation (2 vs. 3 days), opioids use (2.2 ± 0.9 vs. 2.5 ± 1.1 mg IV morphine equivalents/kg), and ↑catheter removed by day 2 (95.0% vs. 80.8%), IV acetaminophen use (100% vs. 66.7%), oral acetaminophen (100% vs. 60.3%), ketorolac use (100% vs. 46.2%), ibuprofen use (48.7% vs. 6.4%) in fast-track group vs. non-fast-track group. =levels fused, operative time, EBL, pain score, 30 days readmission

Shaw et al. 2021 [50]

Retrospective

78 patients: -Fast-track + methadone group (n = 26, mean age 15.1 ± 1.9); −Fast-track group (no methadone, n = 52, mean age 14.9 ± 1.9)

No

PSF (with pedicle screw instrumentation) for AIS

NR

NR

NR

2.7 ± 0.7 and 3.1 ± 0.6 days

0 complications

2 30 days readmission

90 days

↓LOS (2.7 ± 0.7 vs. 3.1 ± 0.6 days), valium (11.3 ± 8.7 vs. 17.7 ± 11.7 mg) in fast-track + methadone group vs. fast-track alone group. =levels fused, operative time, EBL, opioid use, pain score

Smith et al. 2019 [51]

Retrospective

219 patients: -Fast-track group (n = 96, mean age 61.3 ± 13.3, 50.0% females); −Non-fast-track group (n = 123, mean age 60.3 ± 12.9, 56.9% females)

Yes

Lumbar spine fusion surgery

1–2

Coronary artery disease, hypertension, asthma, chronic obstructive pulmonary disease, diabetes mellitus-non-insulin dependent, diabetes mellitus-insulin dependent, history of cerebrovascular accident, anxiety, depression, kidney disease, liver disease, obstructive sleep apnea, substance abuse

NR

92.3 h

2.1% infections

NR

3, 6 and 12 months

↑Dexamethasone use (27% vs. 4.8%), methocarbamol use (62% vs. 44%), anticonvulsants use (67% vs. 22%), and ↓antiemetics use (24% vs. 40%), opioid use with patient-controlled analgesia after 24 h (0% vs. 7%), long-acting opioids use (5.2% vs. 14.6%), muscle relaxants (65.6% vs. 78.9%) in fast-track group vs. non-fast-track group. =LOS, mobility, complication, short-acting opioids use, pain score

Soffin et al. 2019b [52]

Retrospective

61 patients: -Fast-track + microdiscectomy group (n = 34, mean age 46, 50% females); −Fast-track + decompression group (n = 27, mean age 65, 48.4% females)

No

Lumbar microdiscectomy or decompression

1 and 1, 2 or 3

Diabetes mellitus, hypertension, coronary artery disease, chronic obstructive pulmonary disease

NR

285 and 298 min

0 complications

0 90 days readmission

90 days

↓LOS (285 vs. 298 min), operative time (48.8 ± 12.7 vs. 64.1 ± 28.6 min) in fast-track + microdiscectomy group vs. fast-track + decompression group. =EBL, IV fluid, opioids use

Soffin et al. 2019a [53]

Retrospective

33 patients: -Fast-track and ACDF group (n = 25, mean age 58, 80% females); −Fast-track and CDA group (n = 8, mean age 44, 75% females)

No

ACDF or CDA

1, 2, 3

Diabetes, hypertension, chronic obstructive pulmonary disease

NR

416 min

NR

No 90 days readmission

90 days

=Operative time, EBL, LOS, IV fluid, opioids use

Soffin et al. 2019c [54]

Retrospective

36 patients: -Fast-track + OFA group (n = 18, mean age 61.5 ± 18.92,44.4% females, 10 males); −Fast-track + OCA group (n = 18, mean age 60.14 ± 15.4, 44.4% females)

No

Elective lumbar decompression (laminectomy, laminotomy, and/or microdiscectomy)

NR

Hypertension, diabetes mellitus, hyperlipidemia, obstructive sleep apnea

NR

237 and 247 min

NR

NR

NR

↓Perioperative opioid use (2.43 ± 0.86 vs. 38.125 ± 6.11OMEs) in fast-track + OFA group vs. fast-track + OCA group. =LOS, operative time, pain score

Soffin et al. 2020 [55]

RCT

51 patients: -Fast-track group (n = 25, mean age 55 ± 18, 44% females); −Non-fast-track group (n = 26, mean age 54 ± 13, 69.2% females)

Yes

Primary lumbar fusion

1 or 2

Hypertension, asthma/pulmonary disease, coronary artery disease, obstructive sleep apnea

NR

2.8 days

32% nausea, 12% vomiting, 16% ileus, 4% delirium/confusion, 4% DVT/pulmonary embolus, 4% infection, 8% respiratory

NR

56 days

↑QoR40 scores at day 3 (179 ± 14 vs. 170 ± 16), and ↓time to first oral intake, pain score at day 1 (3 vs. 4), opioid use at 24 h (62 vs. 133) and at 48 h (30 vs. 75), IV patient-controlled analgesia duration (16 vs. 26 h), C-reactive protein at 3 days (6.1 vs. 15.9 mg·dl − 1) in fast-track group vs. non-fast-track group. =plasma biomarkers, complications, LOS, time to discharge from physical therapy

Staartjes et al. 2019 [56]

Prospective

Fast-track group: 2579 patients, mean age 48.5 ± 13.5, 45.9% females

No

Tubular microdiscectomy, 1-level robot-guided PLIF or TLIF, mini-open ALIF, or mini-open decompression for lumbar disc herniation, spinal stenosis, spondylolisthesis, facet cysts, or proven DDD

L1–2, L2–3, L3–4, L4–5, L5-S1

NR

NR

1.1 ± 1.2, 1.4 ± 0.7, 1.9 ± 0.6 days

4% complications

0.78% 30 days readmissions, 1.40% 60 days readmissions (67% unmanageable pain, 17% persistent CSF leakage with dizziness and orthostatic headache), 14% reoperation

6 weeks, 1 and 2 years

LOS = 1.1 ± 1.2 days; discharged at day 0 or 1 = 94%; discharged after day 1 = 85% (ALIF) and 52% (TLIF). ↓LOS (1.4 ± 0.7 vs. 1.9 ± 0.6 days) in ALIF vs. TLIF. ↑discharged at day 0 (98% vs. 22%) in discectomy vs. PLIF. ↑PROMs, D ODI, EQ-5D index, EQ-VAS, discharge at day 1 (from 90 to 96%), 1-night hospital stays (from 26 to 85%), and ↓operative time (from 38.8 ± 36.1 to 29.0 ± 22.8 min), complication, nursing costs (by 46.8%), LOS (from 2.4 ± 1.2 to 1.5 ± 0.3 days). =pain

Venkata et al. 2018 [57]

Prospective

Fast-track group: 237 patients (mean age: 57, 40% females)

No

Elective, open, non-instrumented lumbar and cervical spinal decompression and discectomy surgery for degenerative lumbar and cervical spinal conditions causing neural compression

1, 2, 3

NR

NR

< or > 24 h

1.6% disc prolapses, 0.8% hematomas

2.5% readmission (n = 7), reoperation (n = 6)

18 months

↓LOS: short stay = 12 patients (5%), ambulatory = 225 (95%) and day surgery after admission = 126 (53.2%)

Wang et al. 2017 [58]

Retrospective

Fast-track group: 42 patients (mean age 66.1 ± 11.7, 52% females)

No

1- or 2-level unilateral open TLIF (endoscopic decompression, expandable cage with allograft matrix, 2.1 mg rhBMP-2, bilateral pedicle percutaneous screws with 20 ml Exparel and bilateral rods) for spondylolisthesis or a severely degenerated disc with nerve root impingement, radiculopathy from neural compression, back pain from instability

L1–2, L2–3, L3–4, L4–5, L5-S1

NR

NR

1.29 ± 0.9 nights

1 cage displacement, 2 infection of interbody graft with sepsis, 1 atrial fibrillation, 1 upper-extremity DVT, 2 transient radiculitis

1 reoperation (graft migration at 2 months after surgery)

6 weeks, 3, 6, 12, and 24 months

Operative time = 94.6 ± 22.4 min; EBL = 66 ± 30 ml; LOS = 1.29 ± 0.9 nights. ↓ODI score (from 40 ± 13 to 17 ± 11)

Wang et al. 2020 [59]

Retrospective

190 patients: -Fast-track group (n = 95, 72.39 ± 6.12 age, 52.6% females); −Non-fast-track, (n = 95, mean age 70.81 ± 6.27, 57.8% females)

Yes

Lumbar fusion surgery for lumbar disk herniation or spinal stenosis

1 or 2

Hypertension, heart disease, diabetes, osteoporosis, gastrointestinal, psychological symptoms

NR

12.30 ± 3.03

1 spinal fluid leakage, 1 neurological

1 30 days readmission

30 days

↓LOS (12.30 ± 3.03 vs. 15.50 ± 1.88) in fast-track group vs. non-fast-track group. =operative time, levels fused, EBL, pain score, complication, mortality, 30 days readmission

Yang et al. 2020 [60]

Prospective

Fast-track group: 46 patients (mean age 14.3, 89.1% female)

No

PSF (with local autograft and allograft bone graft) for AIS

< or > L2

NR

NR

3.3 days

5% constipation

NR

15 days

LOS = 3.3 days: 1 patient discharge at day 2, 33 at day 3, 9 at day 4, 3 at day 5. Satisfaction on discharge at appropriate time = 80%, at discharge too early = 20%. ↓pain score (3.4 ± 1.6 vs. 4.7 ± 1.6) in appropriate group vs. too early group. =satisfaction, levels fused

Yang et al. 2020 [61]

Retrospective

72 patients: -Fast-track group (n = 51, mean age 70.1 ± 3.9, 28 females); −Non-fast-track group (n = 21, mean age 72.4 ± 5.4, 13 females)

Yes

TLIF (with interbody cage with autologous bone, pedicle screws and rods) for lumbar degenerative diseases (severe degenerative lumbar spinal stenosis, degenerative lumbar spondylolisthesis, lumbar disc herniation) and severe or progressive mechanical low back pain

L4–5

Hypertension, diabetes

NR

9.0 days

NR

NR

1 week, 2 years

↓Operative time (175.0 vs. 189.0 min), EBL (170.0 vs. 197.0 ml), LOS (9.0 vs. 12.0 days), NSAID use (37.50 vs. 45.00 mg), ambulation recovery time (1.0 vs. 2.0 day), VAS pain (2.0 vs. 3.0) at 3 days and 1 month, and ↑Barthel index at 3 days (65.0 vs. 30.0) and at 1 month (95.0 vs. 85.0) in fast-track group vs. non-fast-track group. =levels fused

Yang et al. 2021 [62]

Retrospective

79 patients: -Fast-track group (n = 35, mean age 14.6 ± 2.0, 27 females); −Non-fast-track group (n = 44, mean age 14.5 ± 2.1, 31 females)

Yes

PSF (with pedicle screw-rod system, autogenous local bone graft and allogeneic bone graft, without 3-column osteotomy) for AIS

NR

NR

NR

5.2 ± 1.6 days

2.9% complications

NR

1 year

↓Operative time (231.6 ± 34.7 vs. 290.9 ± 58.4 min), EBL (432.7 ± 201.1 vs. 894.3 ± 316.5 ml), allogeneic blood transfusion (3% vs. 33%), pain relief time (44.3 ± 33.5 vs. 70.5 ± 26.7 h), hemovac drainage (40.3 ± 24.8 vs. 691.7 ± 308.7 ml), drainage removal time (21.8 ± 9.8 vs. 60.4 ± 13.0 h), first ambulation time (23.9 ± 10.6 vs. 73.5 ± 18.3 h), LOS (5.2 ± 1.6 vs. 7.8 ± 1.5 days), PONV (14.3% vs. 34.1%) in fast-track group vs. non-fast-track group. =levels fused, Hb level, pain score, complications

Young et al. 2021 [63]

Retrospective

243 patients: -Fast-track group (n = 97, mean age 62 ± 14, 49 females); −Non-fast-track group (n = 146, mean age 59 ± 13, 66 females)

Yes

ACDF, PCDF, lumbar decompression, posterior lumbar fusion, lumbar microdiscectomy

1, 2, 3, 4, 5+

NR

NR

51 ± 30 h

3 incidental durotomy, 2 surgical site infection

1 instrumentation misplacement requiring operative revision, 1 disc herniation requiring reoperation

30 days

↓Opioid use at day 1 (26 ± 33 vs. 42 ± 409 MMEs) and in opiate-naive patients (16 ± 21 vs. 38 ± 36 MMEs), LOS (51 ± 30 vs. 62 ± 49 h) in fast-track group vs. non-fast-track group. =complications, 30 days readmission, 30 days reoperation time operation

Band et al. 2022 [64]

Prospective

32 patients: -Fast-track group (n = 16); −Non-fast-track group (n = 16)

Yes

Single-level MIS-TLIF for degenerative disease

NR

diabetes, hypertension

NR

1.6 days

NR

NR

NR

↓LOS (1.6 vs. 2.4 days), opioid consumption (51 mg MME vs. 320 mg MME) in fast-track group vs. non-fast-track group

Chen et al. 2022 [65]

Retrospective

207 patients: -Fast-track group (n = 112, mean age 52.86 ± 11.55, 49% females); −Non-fast-track group (n = 95, mean age 54.77 ± 11.66, 60% females)

Yes

Short-level (1- or 2-level) primary open PLIF for lumbar disc herniation, lumbar stenosis, and spondylolisthesis

NR

NR

NR

10.44 ± 3.07

Urinary retention (3.57%), constipation (10.71%), nausea and vomiting (5.36%), wound infection, venous thrombosis, fever, urinary tract infection, paravertebral hematoma, delirium

30-day readmission rate (4.46%), 30-day reoperation rate (2.68%)

30 days

↓LOS (10.44 ± 3.07 vs. 15.29 ± 3.57 days), off-bed time (7.53 ± 2.80 vs. 13.82 ± 3.44 days), complications (28.57% vs. 42.11%), urinary retention (3.57% vs. 11.58%), constipation (10.71% vs. 22.11%), nausea and vomiting (5.36% vs. 13.68%), drainage tube removal time (2 ± 0.65 vs. 3.53 ± 0.63), catheter removal time (1.79 ± 0.68 vs. 3.97 ± 1.15), surgical drainage at day 1–3 (165.20 ± 40.85 vs. 351.31 ± 32.49), intraoperative blood loss (126.61 ± 34.49 vs. 145.24 ± 22.52), financial cost (57,905.94 ± 12,463.50 vs. 62,683.68 ± 12,583.34 yuan), opioid consumption (18.98 ± 11.40 vs. 36.89 ± 15.30 mg), VAS score at day 3 (2.67 ± 1.02,vs. 3.51 ± 0.88), ODI score at day 3 (37.43 ± 10.22 vs. 41.19 ± 8.29), and ↑satisfaction (89.29% vs. 77.89%) in fast-track group vs. non-fast-track group. =wound infection, venous thrombosis, fever, urinary tract infection, paravertebral hematoma, delirium, operative time, 30-day readmission rate, 30-day reoperation rate

Leng et al. 2022 [66]

Retrospective

143 patients: -Fast-track group (n = 70, mean age 53.2 ± 9.3, 44% females); −Non-fast-track group (n = 73, mean age 52.07 ± 10.6, 61% females)

Yes

ACDF for cervical spondylosis, spondylotic myelopathy and radiculopathy

≥3

Diabetes mellitus, hypertension, chronic cardiovascular disease

NR

4 days

2.9% prolonged dysphagia, 1.4% hardware failure, 8.6% dysphagia/dysphonia, 1.4% nausea and vomiting

No 90-day readmission and reoperation

90 days

↓LOS (4 vs. 5 days), operative time, surgical drainage at day 1, costs, complications (dysphagia/dysphonia, hardware failure, nausea and vomiting), and ↑satisfaction, BMD in fast-track group vs. non-fast-track group. =prolonged dysphagia

Porche et al. b2022 [67]

Retrospective

114 patients: -Fast-track group (n = 57, mean age 66.1 ± 11.7, 53% females); −Non-fast-track group (n = 57, mean age 63.4 ± 13.3, 49% females)

Yes

1- or 2-level open TLIF for degenerative disease (spondylolisthesis, spinal stenosis, nerve root compression, recurrent disc herniation, pseudoarthrosis, or adjacent segment disease)

NR

NR

NR

3.6 ± 1.6 days

NR

2 reoperation within 30 days (3.5%, 1 hardware failure and 1 wound dehiscence)

30 days

↓Operative time (141 ± 37 vs. 170 ± 44 min), LOS (3.6 ± 1.6 vs. 4.6 ± 1.7 days), opioid consumption (8 ± 9 vs. 36 ± 38 MME), drains placed (40.4% vs. 96.5%), catheters placed (21% vs. 61%), PCA use (1.8% vs. 86%), and ↑first day of ambulation (0.6 vs. 1.3 days), bowel movement (2.2 vs. 3.0), bladder voiding (0.3 vs. 1.1 days) in fast-track group vs. non-fast-track group. =pain, EBL, complications, readmission rate, drain removal

Porche et al. a2022 [68]

Retrospective

58 patients: -Fast-track group (n = 17 frail, mean age 72.5 ± 4.2, 47% females; n = 26 non-frail, mean age, 73.4 ± 4.6, 62% females); −Non-fast-track group (n = 15 frail, mean age 73.2 ± 4.7, 20% females)

Yes

1- or 2-level open TLIF for spondylolisthesis, spinal stenosis, nerve root compression,recurrent disc herniation, pseudoarthrosis, or adjacent segment disease

NR

NR

NR

3.8 ± 1.9 days

NR

1 reoperation within 30 days with readmission (5.9%, instrumentation failure/wound dehiscence)

30 days

↑Physiological function (3.4 vs. 6.7 days), the first day of assisted-walking (0.7 vs. 1.6 days), first bowel movement (2.3 vs. 3.0 days), first day of bladder voiding (0.3 vs. 2.1 days) and ↓LOS (3.8 ± 1.9 vs. 4.8 ± 1.6 days), drains placed (59% vs. 100%), catheters placed (18% vs. 60%), PCA use (0% vs. 80%) in fast-track group vs. non-fast-track group. =opioid consumption, pain scores, operative time, EBL, complications, drai removal

Sun et al. 2022 [69]

Retrospective

166 patients: -Fast-track group (n = 86, mean age 56.919 ± 11.699, 69% females); −Non-fast-track group (n = 80, mean age, 58.863 ± 10.880, 56% females)

Yes

Lumbar fusion and internal fixation for lumbar spinal stenosis, spondylolisthesis or lumbar disk herniation

NR

NR

NR

10.465 ± 2.237 days

5.81% (3 delayed wound healing, 1 poor wound healing, 1 urinary system infection)

NR

NR

↓LOS (10.465 ± 2.237 vs. 12.050 ± 3.467 days), complication (5.81% vs. 16.25%), ODI score (25.276 ± 50.841 vs. 78.219 ± 3.540), cost (3.547 ± 0.746 vs. 3.746 ± 0.712 (ten thousand yuan), and ↑BI score (81.047 ± 24.479 vs. 21.400 ± 11.208), self-care ability of patients, dependent degree of patients in fast-track group vs. non-fast-track group. =operative time, EBL, VAS score

Wang et al. 2022 [70]

Retrospective

154 patients: -Fast-track group (n = 72, mean age 76.68 ± 4.83, 57% females); −Non-fast-track group (n = 82, mean age 76.38 ± 4.48, 68% females)

Yes

Long-level lumbar fusion for lumbar disc herniation or lumbar spinal stenosis

≥3

Renal, liver, connective tissue, cerebrovascular, peripheral vascular disease, diabetes, myocardial infarction

NR

17.74 ± 5.56 days

N = 6 (2 hypoproteinemia, 1 heart disease, 1 pneumonia, 1 urinary tract infection, 1 spinal fluid leakage)

N = 0

30 days

↓Complication (6 vs. 19), LOS (17.74 ± 5.56 vs. 22.13 ± 12.21 days) in fast-track group vs. non-fast-track group. =operative time, EBL, transfusion, VAS and ODI scores, readmission and mortality rates at 30-day

Zhang et al. 2022 [71]

Retrospective

119 patients: -Fast-track group (n = 56, mean age 52.94 ± 9.23, 39% females); −Non-fast-track group (n = 63, mean age 54.12 ± 10.34, 38% females)

Yes

Dynamic stabilization and discectomy for lumbar disk herniation (spinal stenosis secondary to disk herniation at 2 levels or less and disk herniation at 2 levels or less combined with intervertebral instability)

NR

NR

NR

7.12 ± 4.62 days

N = 0

N = 0

NR

↓VAS and ODI scores, EBL (90.52 ± 35.21 vs. 150.01 ± 70.34 ml), operative time (2.55 ± 1.35 vs. 3.25 ± 1.01 h), LOS (7.12 ± 4.62 vs. 9.66 ± 6.22 days), ambulation time (30.62 ± 17.68 vs. 48.22 ± 12.66 h), and ↑JOA score in fast-track group vs. non-fast-track group