Emerging technologies enhancing ERAS in spine surgery

Enhanced Recovery After Surgery (ERAS) protocols in spine surgery have transformed perioperative care by minimizing surgical stress and accelerating patient recovery. Despite advancements through minimally invasive techniques and multimodal analgesia, challenges such as variable adherence and limited personalization persist. Emerging technologies offer promising solutions to optimize ERAS outcomes. Artificial intelligence (AI) and machine learning are being used to predict complications, personalize recovery protocols, and support clinical decision-making with real-time data analysis. Wearable biosensors and accelerometers enable continuous, wireless monitoring of vital signs and physical activity, facilitating early detection of complications and promoting patient mobility. Remote patient monitoring platforms extend ERAS principles into the home setting, allowing real-time tracking of recovery metrics, early intervention for complications, and enhanced patient engagement through mobile applications. Furthermore, precision medicine approaches—such as pharmacogenomics-guided pain management, individualized rehabilitation strategies, and patient-specific surgical optimization—aim to tailor care based on genetic, functional, and anatomical factors. Although these innovations align with ERAS goals of faster, safer recovery, widespread implementation faces hurdles, including the need for robust clinical validation, clinician and patient education, and demonstration of cost-effectiveness. Nevertheless, early evidence indicates that technology-enhanced ERAS pathways could substantially improve patient-centric outcomes and redefine standards of postoperative spine care. As research progresses and adoption grows, integrating AI, wearables, telehealth, and personalized medicine into ERAS protocols may usher in a new era of smarter, precision-guided recovery for spine surgery patients.