{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:33:06Z","timestamp":1787502786275,"version":"build-2736575974"},"reference-count":36,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","journal-cot.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Orthopaedics and Trauma"],"published-print":{"date-parts":[[2022,7]]},"DOI":"10.1016\/j.jcot.2022.101923","type":"journal-article","created":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T02:24:33Z","timestamp":1655346273000},"page":"101923","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":20,"special_numbering":"C","title":["Perioperative outcomes of general versus spinal anesthesia in the lumbar spine surgery population: A systematic review and meta-analysis of data from 2005 through 2021"],"prefix":"10.1016","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4819-8469","authenticated-orcid":false,"given":"David","family":"Urick","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7933-9394","authenticated-orcid":false,"given":"Brandon","family":"Sciavolino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy Y.","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9505-595X","authenticated-orcid":false,"given":"Dhanesh K.","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8626-0222","authenticated-orcid":false,"given":"Alok","family":"Sharan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7151-2861","authenticated-orcid":false,"given":"Muhammed M.","family":"Abd-El-Barr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"2","key":"10.1016\/j.jcot.2022.101923_bib1","doi-asserted-by":"crossref","first-page":"e317","DOI":"10.3928\/01477447-20161219-01","article-title":"Spinal anesthesia in elderly patients undergoing lumbar spine surgery","volume":"40","author":"Lessing","year":"2017","journal-title":"Orthopedics"},{"issue":"5","key":"10.1016\/j.jcot.2022.101923_bib2","doi-asserted-by":"crossref","first-page":"713","DOI":"10.14444\/7103","article-title":"Spinal anesthesia for geriatric lumbar spine surgery: a comparative case series","volume":"14","author":"Lessing","year":"2020","journal-title":"Internet J Spine Surg"},{"issue":"1","key":"10.1016\/j.jcot.2022.101923_bib3","first-page":"5","article-title":"Microdiscectomy: spinal anesthesia offers optimal results in general patient population","volume":"16","author":"McLain","year":"2007","journal-title":"J\u00a0Surg Orthop Adv"},{"issue":"1","key":"10.1016\/j.jcot.2022.101923_bib4","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.surneu.2008.08.003","article-title":"A\u00a0prospective randomized trial comparing the technique of spinal and general anesthesia for lumbar disk surgery: a study of 100 cases","volume":"71","author":"Sadrolsadat","year":"2009","journal-title":"Surg Neurol"},{"issue":"3","key":"10.1016\/j.jcot.2022.101923_bib5","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1111\/anae.13702","article-title":"Impact of spinal anaesthesia vs. general anaesthesia on peri-operative outcome in lumbar spine surgery: a systematic review and meta-analysis of randomised, controlled trials","volume":"72","author":"Meng","year":"2017","journal-title":"Anaesthesia"},{"key":"10.1016\/j.jcot.2022.101923_bib6","doi-asserted-by":"crossref","first-page":"b2700","DOI":"10.1136\/bmj.b2700","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration","volume":"339","author":"Liberati","year":"2009","journal-title":"BMJ"},{"key":"10.1016\/j.jcot.2022.101923_bib7","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"10.1016\/j.jcot.2022.101923_bib8","article-title":"ROBINS-I: a tool for assessing risk of bias in non-randomized studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"issue":"1","key":"10.1016\/j.jcot.2022.101923_bib9","article-title":"Methodological quality (risk of bias) assessment tools for primary and secondary medical studies: what are they and which is better?","volume":"7","author":"Ma","year":"2020","journal-title":"Mil Med Res"},{"issue":"1","key":"10.1016\/j.jcot.2022.101923_bib10","first-page":"5","article-title":"Microdiscectomy: spinal anesthesia offers optimal results in general patient population","volume":"16","author":"McLain","year":"2007","journal-title":"J\u00a0Surg Orthop Adv"},{"issue":"1","key":"10.1016\/j.jcot.2022.101923_bib11","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.surneu.2008.08.003","article-title":"A\u00a0prospective randomized trial comparing the technique of spinal and general anesthesia for lumbar disk surgery: a study of 100 cases","volume":"71","author":"Sadrolsadat","year":"2009","journal-title":"Surg Neurol"},{"issue":"12","key":"10.1016\/j.jcot.2022.101923_bib12","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1016\/j.jocn.2010.04.031","article-title":"Lumbar microdiscectomy under epidural anaesthesia with the patient in the sitting position: a prospective study","volume":"17","author":"Nicassio","year":"2010","journal-title":"J\u00a0Clin Neurosci"},{"issue":"7","key":"10.1016\/j.jcot.2022.101923_bib13","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.jclinane.2011.01.008","article-title":"Epidural anesthesia as a novel anesthetic technique for anterior lumbar interbody fusion","volume":"23","author":"Schroeder","year":"2011","journal-title":"J\u00a0Clin Anesth"},{"issue":"3","key":"10.1016\/j.jcot.2022.101923_bib14","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.pjnns.2014.05.005","article-title":"Perioperative outcome and cost-effectiveness of spinal versus general anesthesia for lumbar spine surgery","volume":"48","author":"Kahveci","year":"2014","journal-title":"Neurol Neurochir Pol"},{"issue":"5","key":"10.1016\/j.jcot.2022.101923_bib15","first-page":"685","article-title":"Lumbar microdiscectomy under spinal and general anesthesia: a comparative study","volume":"25","author":"Dagistan","year":"2015","journal-title":"Turk Neurosurg"},{"issue":"8","key":"10.1016\/j.jcot.2022.101923_bib16","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1016\/j.jocn.2015.02.018","article-title":"General versus epidural anesthesia for lumbar microdiscectomy","volume":"22","author":"Ulutas","year":"2015","journal-title":"J\u00a0Clin Neurosci"},{"key":"10.1016\/j.jcot.2022.101923_bib17","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.wneu.2016.02.022","article-title":"Cost analysis of spinal versus general anesthesia for lumbar diskectomy and laminectomy spine surgery","volume":"89","author":"Agarwal","year":"2016","journal-title":"World Neurosurg"},{"key":"10.1016\/j.jcot.2022.101923_bib18","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.jclinane.2018.01.004","article-title":"Spinal versus general anesthesia for lumbar spine surgery in high risk patients: perioperative hemodynamic stability, complications and costs","volume":"46","author":"Finsterwald","year":"2018","journal-title":"J\u00a0Clin Anesth"},{"issue":"4","key":"10.1016\/j.jcot.2022.101923_bib19","doi-asserted-by":"crossref","first-page":"422","DOI":"10.4055\/cios.2019.11.4.422","article-title":"A\u00a0survey on the short-term outcome of microlumbar discectomy with general versus spinal anesthesia","volume":"11","author":"Dashtbani","year":"2019","journal-title":"Clin Orthop Surg"},{"issue":"6","key":"10.1016\/j.jcot.2022.101923_bib20","first-page":"843","article-title":"Effects of anesthesia protocol on perioperative outcomes and costs of lumbar microdiscectomies","volume":"29","author":"Kilic","year":"2019","journal-title":"Turk Neurosurg"},{"key":"10.1016\/j.jcot.2022.101923_bib21","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.jcot.2020.11.017","article-title":"Comparative outcome analysis of spinal anesthesia versus general anesthesia in lumbar fusion surgery","volume":"13","author":"Sekerak","year":"2020","journal-title":"J\u00a0Clin Orthop Trauma"},{"key":"10.1016\/j.jcot.2022.101923_bib22","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.jcot.2020.12.032","article-title":"Efficacy, safety, and reliability of surgery on the lumbar spine under general versus spinal anesthesia- an analysis of 64 cases","volume":"16","author":"Ahmed Jonayed","year":"2021","journal-title":"J\u00a0Clin Orthop Trauma"},{"issue":"1","key":"10.1016\/j.jcot.2022.101923_bib23","first-page":"102","article-title":"General anesthesia compared to spinal anesthesia for patients undergoing lumbar vertebral surgery: a meta-analysis of randomized controlled trials","volume":"10","author":"De Cassai","year":"2020","journal-title":"J\u00a0Clin Med"},{"issue":"6","key":"10.1016\/j.jcot.2022.101923_bib24","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.jclinane.2006.02.006","article-title":"Does neuraxial anesthesia reduce intraoperative blood loss? A meta-analysis","volume":"18","author":"Richman","year":"2006","journal-title":"J\u00a0Clin Anesth"},{"issue":"4","key":"10.1016\/j.jcot.2022.101923_bib25","doi-asserted-by":"crossref","DOI":"10.1001\/jamasurg.2017.6233","article-title":"Understanding costs of care in the operating room","volume":"153","author":"Childers","year":"2018","journal-title":"JAMA Surg"},{"issue":"4","key":"10.1016\/j.jcot.2022.101923_bib26","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1177\/2192568218795867","article-title":"An analysis of the cost-effectiveness of spinal versus general anesthesia for lumbar spine surgery in various hospital settings","volume":"9","author":"Morris","year":"2019","journal-title":"Global Spine J"},{"issue":"3","key":"10.1016\/j.jcot.2022.101923_bib27","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.jocn.2014.08.024","article-title":"Cost analysis of spinal and general anesthesia for the surgical treatment of lumbar spondylosis","volume":"22","author":"Walcott","year":"2015","journal-title":"J\u00a0Clin Neurosci"},{"key":"10.1016\/j.jcot.2022.101923_bib28","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.jss.2018.03.022","article-title":"Prolonged operative duration is associated with complications: a systematic review and meta-analysis","volume":"229","author":"Cheng","year":"2018","journal-title":"J\u00a0Surg Res"},{"issue":"6","key":"10.1016\/j.jcot.2022.101923_bib29","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1097\/BRS.0000000000000163","article-title":"Operative duration as an independent risk factor for postoperative complications in single-level lumbar fusion: an analysis of 4588 surgical cases","volume":"39","author":"Kim","year":"2014","journal-title":"Spine"},{"issue":"1","key":"10.1016\/j.jcot.2022.101923_bib30","first-page":"5","article-title":"Relation of improved postoperative nausea\/vomiting quality metric to physician incentive pay","volume":"32","author":"Hutson","year":"2019","journal-title":"SAVE Proc"},{"issue":"2","key":"10.1016\/j.jcot.2022.101923_bib31","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0228805","article-title":"General anesthesia technique and perception of quality of postoperative recovery in women undergoing cholecystectomy: a randomized, double-blinded clinical trial","volume":"15","author":"Carli","year":"2020","journal-title":"PLoS One"},{"issue":"2","key":"10.1016\/j.jcot.2022.101923_bib32","first-page":"321","article-title":"Lasting effects of general anesthetics on the brain in the young and elderly: \"mixed picture\" of neurotoxicity, neuroprotection and cognitive impairment","volume":"33","author":"Wu","year":"2019","journal-title":"J\u00a0Anesth"},{"issue":"1","key":"10.1016\/j.jcot.2022.101923_bib33","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1186\/s12871-019-0903-7","article-title":"Anesthesiology and cognitive impairment: a narrative review of current clinical literature","volume":"19","author":"Belrose","year":"2019","journal-title":"BMC Anesthesiol"},{"issue":"1","key":"10.1016\/j.jcot.2022.101923_bib34","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1186\/s12871-019-0867-7","volume":"19","author":"Brown","year":"2019","journal-title":"BMC Anesthesiol"},{"issue":"1","key":"10.1016\/j.jcot.2022.101923_bib35","doi-asserted-by":"crossref","first-page":"9232","DOI":"10.1038\/s41598-020-66276-3","article-title":"Incidence & risk factors of postoperative delirium after spinal surgery in older patients","volume":"10","author":"Kang","year":"2020","journal-title":"Sci Rep"},{"issue":"10","key":"10.1016\/j.jcot.2022.101923_bib36","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.bjae.2019.06.001","article-title":"Spinal anaesthesia for ambulatory surgery","volume":"19","author":"Rattenberry","year":"2019","journal-title":"BJA Educ"}],"container-title":["Journal of Clinical Orthopaedics and Trauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S097656622200159X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S097656622200159X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T08:01:13Z","timestamp":1760860873000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S097656622200159X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":36,"alternative-id":["S097656622200159X"],"URL":"https:\/\/doi.org\/10.1016\/j.jcot.2022.101923","relation":{},"ISSN":["0976-5662"],"issn-type":[{"value":"0976-5662","type":"print"}],"subject":[],"published":{"date-parts":[[2022,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Perioperative outcomes of general versus spinal anesthesia in the lumbar spine surgery population: A systematic review and meta-analysis of data from 2005 through 2021","name":"articletitle","label":"Article Title"},{"value":"Journal of Clinical Orthopaedics and Trauma","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jcot.2022.101923","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 Delhi Orthopedic Association. All rights reserved.","name":"copyright","label":"Copyright"}],"article-number":"101923"}}