REGIONAL ANESTHESIA AND EARLY REHABILITATION IN JOINT AND SPINE SURGERY: CURRENT EVIDENCE, CLINICAL APPLICATIONS, AND FUTURE PERSPECTIVES

Abstract

Regional anesthesia is increasingly used in joint and spine surgery to improve perioperative pain control while supporting early mobilization and functional recovery. Its role has expanded within multimodal analgesia and enhanced recovery pathways, where preservation of motor function and timely rehabilitation are important clinical goals. To review current evidence on the clinical applications of regional anesthesia in joint and spine surgery and evaluate its relationship with early rehabilitation, functional recovery, safety, and emerging perioperative strategies. A comprehensive review approach was used to identify relevant literature on regional anesthesia, joint surgery, spine surgery, postoperative analgesia, early mobilization, rehabilitation, and enhanced recovery. Eligible studies were organized thematically and synthesized according to clinical applications, rehabilitation outcomes, safety considerations, and future developments.  Regional anesthesia was associated with improved postoperative pain management, reduced reliance on systemic analgesia, and better integration with rehabilitation-focused care. In joint and spine surgery, procedure-specific regional techniques may support early mobilization, physiotherapy participation, and discharge readiness when excessive motor blockade is avoided. ERAS pathways further strengthen these benefits through coordinated multimodal care. Emerging approaches include ultrasound-guided techniques, motor-sparing blocks, personalized pain management, and prolonged local anesthetic delivery. Regional anesthesia is evolving toward a recovery-centered and individualized component of perioperative care, with future research needing greater emphasis on standardized functional and rehabilitation outcomes.