SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2024
Comparative outcomes of awake spine surgery under spinal versus general anesthesia: a comprehensive systematic review and meta-analysis.
Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Burr hole evacuation of chronic subdural hematoma in general versus local anesthesia: a systematic review and meta-analysis.Acta neurochirurgica · 2025Pooled it
- Spinal Anesthesia With Use of an Erector Spinae Plane Block Is Associated With Reduced Opioid Use and Improved Clinical Outcomes in Single-Level Transforaminal Lumbar Interbody Fusions: Evolution of Techniques and a Single-Surgeon Retrospective Analysis.International journal of spine surgery · 2026Article
- Comparing the Effect of Spinal Versus General Anesthesia on Postoperative Opioid Use in Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Patient Matched Study.Journal of clinical medicine · 2026Article
- Reconsidering Anesthesia in Lumbar Surgery: An Umbrella Review of Awake Versus General Anesthesia.Journal of clinical medicine · 2025Review
- General Anesthesia or Spinal Anesthesia and Serum Endocan Release After Surgery: A Prospective Observational Study.Journal of clinical medicine · 2025Article
- Unilateral Biportal Endoscopic Decompression for Degenerative Lumbar Spinal Stenosis Under Local Anesthesia in Elderly Patients with Medical Comorbidities.Orthopaedic surgery · 2025Article
- Spinal Anesthesia Results in Lower Costs Compared to General Anesthesia for Patients Undergoing Lumbar Fusion-A Matched Cohort Study.Journal of clinical medicine · 2025Article
- Spinal Anesthesia and Digital Anxiolysis (SPIDA) for the treatment of lumbar spinal stenosis - a feasibility study.Neurosurgical review · 2025Article
- Comparative analysis of spinal anesthesia versus general anesthesia in single-port access laparoscopic adnexal surgery: a propensity score matching study.BMC women's health · 2025Article
- Should Spinal Anesthesia Be Used for Spine Surgery: A Case Report.Case reports in anesthesiology · 2025Article
- Analysis of the risk difference in post-spinal anesthesia hypotension between primiparas and multiparas in cesarean section.Frontiers in surgery · 2025Article
- Short-term 30-day adverse events following awake versus asleep deep brain stimulation for movement disorders: a nationwide registry-based study.Brain & spine · 2025Article
- Systematic review and meta-analysis of spinal versus general anesthesia in decompressive surgeries of the lumbar spine.Brain & spine · 2025Review
- Spinal Anesthesia for Awake Spine Surgery: A Paradigm Shift for Enhanced Recovery after Surgery.Journal of clinical medicine · 2024Review
- Interarticular device surgery for lumbar facet syndrome: Diagnostic and therapeutic significance of injection tests and single-photon emission computed tomography/computed tomography.Journal of craniovertebral junction & spineArticle
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAwake surgery, under spinal anesthesia (SA), is an alternative to surgery under general anesthesia (GA), in neurological and spine surgery. In the literature, there seem to be some evidence supporting benefits associated with the use of this anesthetic modality, as compared to GA. Currently, there is a notable lack of updated and comprehensive review addressing the complications associated with both awake SA and GA in spine surgery. We hence aimed to perform a systematic review of the literature and meta-analysis on the topic.
methodsA systematic search was conducted to identify studies that assessed SA in spine surgery from database inception to April 14, 2023, in PubMed, Medline, Embase, and Cochrane databases. Outcomes of interest included estimated blood loss, length of hospital stay, operative time, and overall complications. Meta-analysis was conducted using random effects models.
resultsIn total, 38 studies that assessed 7820 patients were included. The majority of the operations that were treated with SA were single-level lumbar cases. Awake patients had significantly shorter lengths of hospital stay (Mean difference (MD): - 0.40 days; 95% CI - 0.64 to - 0.17) and operative time (MD: - 19.17 min; 95% CI - 29.68 to - 8.65) compared to patients under GA. The overall complication rate was significantly higher in patients under GA than SA (RR, 0.59 [95% CI 0.47-0.74]). Patients under GA had significantly higher rates of postoperative nausea/vomiting RR, 0.60 [95% CI 0.39-0.90]) and urinary retention (RR, 0.61 [95% CI 0.37-0.99]).
conclusionsPatients undergoing awake spine surgery under SA had significantly shorter operations and hospital stays, and fewer rates of postoperative nausea and urinary retention as compared to GA. In summary, awake spine surgery offers a valid alternative to GA and added benefits in terms of postsurgical complications, while being associated with relatively low morbidity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.