Exploring the perioperative application effect of a process based communication model combined with the concept of accelerated recovery after surgery (ERAS) in children with congenital spi- nal deformities (CS), and summarizing clinical experience. Methods This study is a prospective study. A to- tal of 68 pediatric patients with CS who underwent surgical treatment in our hospital from February 2022 to Feb- ruary 2023 were selected as the study subjects. They were divided into a study group (n=34) and a control group (n=34) based on management mode. The control group adopted a simple ERAS perioperative manage- ment model, while the research group adopted a procedural communication model combined with ERAS philoso- phy for perioperative intervention. Compared the time of first postoperative discharge, wound healing time, aver- age hospital stay, Chinese version of the screening chart (screen for child anxiety related emotional disorders, SCARED) Score, Chinese version of children Depression Disorder scale (depression self-rating scale for chil- dren, DSRSC) differences in scores, treatment adherence scores, number of ERAS measures completed, compli- cation rate, and pain scores. Results Among all patients, 27 were male and 41 female, mean age (8.31 ± 3.79) years, and there was no significant difference between the baseline data of the two groups (P>0.05). The postoperative time of first discharge and wound healing time in the study group were (32.76 ±5.57) h and (8.41±1.65) d, significantly earlier than the control group (62.94±7.81) h and (9.56±2.60) d (first discharge time t=18.345, P<0.001; wound healing time 12.173,P=0.033). The mean hospital day of stay in the study group was (11.12±2.14) d, significantly shorter than d (15.18±2.48) in the control group (17.221,P<0.001). Tthe two groups' admission SCARED score [Study group (20.65 ±2.01) s. Control group (20.18±2.17), 0.928, P=0.357] and DSRSC score (study group (12.59±2.12) rs, control group (12.68±2.07), 0.174,P=0.863] not significant (P greater than 0.05). However, the SCARED and DSRSC scores of the study group were (12.35 ±2.10) and (9.88±1.70), significant lower (18.59± 1.79) and (11.09±1.85) points than the control group, The differences were statistically significant (P was less than 0.05); [Study group (13.76 ±1.44) ts. control group (9.32 ± 1.84), 11. 102, P<0.001], number of items completed by ERAS measures [Study group (15.91 ±1.49) rs. Control group (13.35 ± 1.54),16.987,P<0.001],complication rate (5.88% of the study group rs. 23.53 of the control group, x = 4.221,P=0.040) and pain score [study group (2.91±0.87) zs. control group (3.76 ± 1.39),1 = 3.031,P=0.003] were all superior over the control group. Conclusions The application of a procedural communication model combined with ERAS concept in perioperative management of CS patients has a better effect, which can effectively improve the postoperative rehabilitation level and treatment compliance of patients, reduce their psychological stress level, and reduce the incidence of complications. [ABSTRACT FROM AUTHOR]