Table 1 Individual components of enhanced recovery pathway in spinal surgery, grouped according to care delivery episode

1. Preadmission information, education and counseling

8. Perioperative blood conservation strategies

17. Thromboprophylaxis

2. Risk assessment, preoperative optimization, including lifestyle factor modification

9. Minimally invasive surgical approaches

18. Urinary drainage

2.1 Preoperative risk stratification

10. Skin preparation and antimicrobial prophylaxis

19. Postoperative nutrition and fluid management

2.2 Preoperative optimization

11. Local anesthetic infiltration

20. Postoperative glycemic control

2.3 Alcohol use

12. Anesthetic protocol

21. Early mobilization

2.4 Tobacco use

13. Prevention of post-operative nausea and vomiting

22. Audit

3. Prehabilitation

14. Maintenance of normothermia

4. Pre-operative nutritional care

15. Fluid management

4.1 Pre-operative nutritional screening

16. Perioperative analgesic measures

4.2 Pre- and peri-operative immune-nutrition

5. Management of anemia

6. Preoperative fasting and carbohydrate loading

7. Pre-emptive analgesia