Early mobilization in spine decompression surgery: insights from one of the first monocentric studies in Switzerland

Introduction: The global rise in the aging population has increased the demand for self-sufficiency in older age and contributed to a higher number of spinal surgeries, driving up healthcare costs. Enhanced Recovery After Surgery (ERAS) protocols aim to improve outcomes by promoting early mobilization, which has shown benefits but lacks standardization in spinal surgery. This study evaluates the impact of early mobilization on outcomes after spinal decompression surgery in Switzerland. Methods: This retrospective study analyzed data from 123 patients who underwent lumbar decompression or microdiscectomy between January and December 2021 at a specialized spine unit. Patients were assigned to an Early Mobilization (EM) group or a control group based on the surgeon’s discretion. The EM group began mobilization on the day of surgery; the control group started the day after. Propensity score matching was used to reduce bias, resulting in 96 matched patients (48 per group, mean age: 56.0 ± 15.7 years). Local infiltration analgesia (LIA) was administered in a subset of patients in both groups. Outcomes included length of hospital stay (LOS), pain (VAS), and disability (COMI-back), assessed preoperatively and three months postoperatively. Results: The EM group had a significantly shorter LOS (3.7 vs. 5.2 days; p < 0.0001). Both groups showed similar improvements in pain and COMI scores (EM: − 4.4; control: − 4.7; p < 0.0001), with no significant differences between groups. LIA had no measurable impact on LOS or opioid use. Complication rates were similar, and patient satisfaction was high in the EM group. Conclusion: Early mobilization after lumbar decompression surgery safely reduces hospital stay without increasing complications or opioid use. These findings support early mobilization as an effective component of ERAS protocols. Further studies with larger cohorts are warranted.