Evidence map›Paper›PMID 41824155›Full record

SynthesisJournal of neuro-oncology2026

Application of enhanced recovery after surgery for patients with spinal metastasis: a systematic review and meta-analysis.

Shahab Aldin Sattari, S Farzad Maroufi, John N Theodore, Kelly Jiang, Albert Antar, Wuyang Yang, Tej D Azad, A Daniel Davidar, Carly Weber-Levine, Louis Chang and 8 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

18 authors.

Shahab Aldin SattariDepartment of Neurosurgery, University of Missouri-Kansas City, Kansas City, MO, USA.
S Farzad MaroufiDepartment of Neurological Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 7-113, Baltimore, MD, 21287, USA.
John N TheodoreEmory School of Medicine, Atlanta, GA, USA.
Kelly JiangDepartment of Neurological Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 7-113, Baltimore, MD, 21287, USA.
Albert AntarDepartment of Neurosurgery, Weill Cornell Medicine, New York, NY, USA.
Wuyang YangDepartment of Neurosurgery, University of Arizona, Tucson, AZ, USA.
Tej D AzadDepartment of Neurological Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 7-113, Baltimore, MD, 21287, USA.
A Daniel DavidarDepartment of Neurological Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 7-113, Baltimore, MD, 21287, USA.
Carly Weber-LevineDepartment of Neurological Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 7-113, Baltimore, MD, 21287, USA.
Louis ChangDepartment of Neurological Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 7-113, Baltimore, MD, 21287, USA.
Alexander C WhitingAllegheny General Hospital, Drexel University of Medical College, Pittsburgh, PA, USA.
Daniel LubelskiDepartment of Neurological Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 7-113, Baltimore, MD, 21287, USA.
Ali BydonDepartment of Neurological Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 7-113, Baltimore, MD, 21287, USA.
Timothy WithamDepartment of Neurological Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 7-113, Baltimore, MD, 21287, USA.
Jon WeingartDepartment of Neurological Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 7-113, Baltimore, MD, 21287, USA.
Chetan BettegowdaDepartment of Neurological Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 7-113, Baltimore, MD, 21287, USA.
Allan BelzbergDepartment of Neurological Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 7-113, Baltimore, MD, 21287, USA.
Nicholas TheodoreDepartment of Neurological Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 7-113, Baltimore, MD, 21287, USA. theodore@jhmi.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveEnhanced Recovery After Surgery (ERAS) has been used to improve recovery and outcomes after surgical operations. However, the literature on implementing the ERAS concept in spine metastasis is sparse. This systematic review and meta-analysis sought to shed light on this topic.

methodMEDLINE, PubMed, and Embase were searched. The primary outcomes were hospital LOS and complications. The secondary outcomes were duration of operation, operative blood loss, postoperative visual analogue scale (VAS) and morphine equivalent daily dose (MEDD), time to ambulation, time to urinary catheter removal, regular diet, radiation, and systemic internal therapy.

resultsIncluded four studies yielded 975 patients, from which 442 and 533 patients underwent surgery with and without ERAS, respectively. The two groups were similar in age, male gender, comorbidities, smoking, Eastern Cooperative Oncology Group (ECOG) Performance Status score, location of surgery, and source of primary cancers. In the ERAS group, hospital length of stay (LOS MD= -1.97 days [-3.07, -0.87], p = 0.005) was shorter; however, both groups were similar in complications (OR = 0.71 [0.27, 1.82], p = 0.470). Furthermore, operative blood loss (MD= -204.35 ml [-400.66, -8.03], p = 0.04), third-day postoperative VAS score (MD= -0.95 [-1.48, -0.41], p = 0.005), postoperative MEDD (MD= -206.81 mg [-319.62, -94.01], p = 0.003), time to ambulation (MD= -33.81 h [-43.91, -23.71], p < 0.001), time to urinary catheter removal (MD= -30.75 h [-33.99, -27.50], p < 0.001), time to regular diet (MD= -19.67 h [-32.62, -6.72], p = 0.003), time to radiation (MD= -6.05 days [-6.87, -5.24], p < 0.001), and time to systemic internal therapy (MD= -4.96 days [-5.79, -4.13], p < 0.001) were lower in the ERAS group. In addition, duration of operation was similar (MD = 0.06 min [-34.45, 34.57], p = 1).

conclusionThis study showed that the application of ERAS for patients with spinal metastases is beneficial in terms of operative blood loss, pain management, and time metric values. The possible effect of ERAS protocols on perioperative complications deserves further investigation. We recommend considering the ERAS concept for patients with spinal metastases.

Indexed as

Enhanced Recovery After SurgeryRecovery of FunctionSpinal NeoplasmsHumansLength of StayCancerEnhanced recoveryMetastasisMorbidityOncologySpineSurgery

Identifiers

PMID41824155

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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.