Evidence map›Paper›PMID 41493498›Full record

SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2026

The impact of workers' compensation claims on outcomes of cervical spine surgery: a meta-analysis.

Ralph Maroun, Mohammad Daher, Ethan Cottrill, Bryan Youssef, Yorgho Maalouf, Moussa Samaha, Richard K Hurley, William F Lavelle, Peter G Passias, Bassel Diebo and 2 more

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ralph MarounLebanese University, Beirut, Lebanon.
Mohammad DaherBrown University, Providence, USA. mohdaher1@hotmail.com.
Ethan CottrillDuke University, Durham, USA.
Bryan YoussefHôtel-Dieu de France, Beirut, Lebanon.
Yorgho MaaloufHôtel-Dieu de France, Beirut, Lebanon.
Moussa SamahaHôtel-Dieu de France, Beirut, Lebanon.
Richard K HurleySan Antonio Military Medical Center, San Antonio, USA.
William F LavelleSyracuse University, Syracuse, USA.
Peter G PassiasDuke University, Durham, USA.
Bassel DieboBrown University, Providence, USA.
Amer SebaalyHôtel-Dieu de France, Beirut, Lebanon.
Alan H DanielsBrown University, Providence, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designMeta-analysis.

objectiveThis meta-analysis aims to clarify the clinical and functional impact of Workers' compensation (WC) status on cervical spine surgery outcomes.

backgroundWork-related musculoskeletal disorders can lead to significant disability, impaired productivity, and quality of life. WC status in patients has been linked to worse outcomes following orthopedic surgeries, including cervical spine procedures (ACDF, CDA). Studies analyzing the influence of WC claims on different cervical spine surgeries report contradicting results.

methodsAdhering to the PRISMA guidelines, Google Scholar, Cochrane, and PubMed were searched since inception until May 2025. The data that was extracted included overall complications, number of reoperations, surgery-related outcomes (estimated blood loss (EBL), operative time, and length of stay (LOS)), the improvement in patient reported outcome measures (PROMS) at 1 year post-operatively, number of patients returning to work, and mean time to return to work.

resultsEight retrospective studies met the inclusion criteria, including 801 patients in the WC group and 1102 in the NWC group. The patients in the WC group had a shorter operative time (Mean difference = - 2.83 min; 95% CI - 5.03 to - 0.64, p = 0.01), and LOS (Mean difference = - 2.62 h; 95% CI - 4.61 to - 0.63, p = 0.01). On the other hand, they had a worse improvement in neck pain (Standardized mean difference  = - 0.32; 95% CI - 0.45 to - 0.19, p < 0.001), and arm pain (Standardized mean difference = - 0.26; 95% CI - 0.39 to - 0.13, p < 0.001), as well as a longer time to return to work (Mean difference = 4.53 weeks; 95% CI 2.70-6.36, p < 0.001).

conclusionPatients with WC claims had worse improvement in arm and neck pain and needed more time to return to work. These results highlight the impact of WC claims have on cervical spine surgery outcomes, making compensation status an essential factor to consider in clinical evaluation and patient counseling.

Indexed as

Cervical VertebraeOrthopedic ProceduresWorkers' CompensationBlood Loss, SurgicalHumansLength of StayOperative TimePatient Reported Outcome MeasuresPostoperative ComplicationsReoperationReturn to WorkTreatment OutcomeCervical spine surgeryNon-workers’ compensationReturn to workWorkers’ compensation

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Registered trials

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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.