SynthesisBritish journal of anaesthesia2025
Optimising postoperative spine outcomes: an umbrella review of enhanced recovery after spinal surgery (ERASS) protocols.
Synthesis in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Integrating Nonpharmacological Options Into Perioperative Pain Care: A Cluster Randomized Clinical Trial.JAMA network open · 2026Trial
- Dexmedetomidine-Ketamine-Based Multimodal General Anesthesia with Electroencephalographic Spectrogram-Guided Titration Improves Early Recovery After Lumbar Spine Fusion in Older Adults: A Randomized Controlled Trial.Drug design, development and therapy · 2026Trial
- ERAS Protocol Elements and Neurosurgery-Specific Considerations: A Narrative Review.Turkish journal of anaesthesiology and reanimation · 2026Article
- Factors Associated with the Early Ambulation After Elective Lumbar Spinal Surgery: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Endoscopic Spine Surgery vs. Conventional Approaches for Lumbar Spondylolisthesis: Systematic Review and Meta-Analysis.Journal of clinical medicine · 2026Review
- An Update on Pain Management in Pediatric Spine Surgery.Current reviews in musculoskeletal medicine · 2026Review
- Risk factors for immediate severe pain in patients with thoracolumbar junction fracture treated with percutaneous pedicle screw fixation: a retrospective study of 598 patients.Journal of orthopaedic surgery and research · 2026Article
- Article
- Interpretable prediction of prolonged length of stay for patients undergoing lumbar disc herniation surgery based on machine learning and SHAP.BMC health services research · 2026Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnhanced Recovery After Surgery (ERAS) protocols aim to improve recovery, reduce complications, and optimise surgical outcomes. Despite increasing use in spinal surgery, no standardised ERAS for spinal surgery (ERASS) exists and evidence synthesis is limited. This umbrella review consolidates findings from systematic reviews (SRs) and meta-analyses (MAs) to evaluate the clinical and economic impact of ERASS and identify research gaps.
methodsA systematic search of MEDLINE, Embase, Cochrane Database of Systematic Reviews, and Web of Science (1990-2024) identified SRs and MAs on ERASS. Data extraction followed Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and Preferred Reporting Items for Overviews of Reviews (PRIOR), with quality assessed using AMSTAR-2 and ROBIS. Overlapping primary studies were removed before recalculating pooled estimates using fixed or random-effects models based on heterogeneity. Primary outcomes included length of stay, postoperative complications, readmission rates, healthcare costs, pain scores, and opioid consumption.
resultsSeventeen SRs and 55 MAs (319 primary studies; n=221 605 participants) were included. ERASS significantly reduced length of stay (-1.55 days; 95% confidence interval [CI] -1.83 to -1.27 days; P<0.01), postoperative complications (relative risk=0.61; 95% CI 0.52-0.72; P<0.01), opioid consumption (-7.26 mg morphine equivalents; 95% CI -10.82 to -3.70 mg; P<0.01), and healthcare costs (-$1029.41 per patient; 95% CI -$1630.17 to -$428.65; P<0.01). Readmission rates were not significantly impacted (relative risk=0.91; P=0.38). Pain scores showed a modest, non-significant reduction (-0.27; 95% CI -0.66 to 0.13; P=0.19). High heterogeneity was observed, reflecting protocol and design variation.
conclusionsERASS protocols significantly improve surgical efficiency and safety. Standardised guidelines and future research addressing heterogeneity, under-represented ERASS elements, and long-term outcomes are needed. SYSTEMATIC REVIEW PROTOCOL: PROSPERO (CRD42024578786).
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