{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T18:52:08Z","timestamp":1793904728976,"version":"4.8.0"},"reference-count":50,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"crossref","award":["2025JJ81082"],"award-info":[{"award-number":["2025JJ81082"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Key Clinical Technique of Guangzhou","award":["2024P-ZD37"],"award-info":[{"award-number":["2024P-ZD37"]}]},{"name":"Guangdong Provincial Basic and Applied Basic Research Fund Project - Natural Science Foundation of Guangdong Province","award":["2023A1515110546"],"award-info":[{"award-number":["2023A1515110546"]}]},{"name":"China Postdoctoral Science Fund","award":["2024M751317"],"award-info":[{"award-number":["2024M751317"]}]},{"name":"President Foundation of The Third Affiliated Hospital of Southern Medical University","award":["YQ202308"],"award-info":[{"award-number":["YQ202308"]}]},{"name":"Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration"},{"name":"Ministry of Education","award":["BZ2024002"],"award-info":[{"award-number":["BZ2024002"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Enhanced Recovery After Surgery (ERAS) is gaining traction in spine surgery, yet high-level evidence specifically for Anterior Cervical Discectomy and Fusion (ACDF) remains sparse. This meta-analysis systematically evaluates the clinical efficacy and safety of ERAS protocols in patients undergoing ACDF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA 2020 and AMSTAR-2 guidelines, we searched Embase, PubMed, Cochrane Library, and Web of Science databases from their inception to December 2025. The Newcastle-Ottawa Scale (NOS) was employed to appraise quality. Pooled estimates of mean differences (MDs) or odds ratios (ORs) were derived using a random-effects model. Sensitivity and subgroup analyses were additionally executed. Primary outcomes encompassed postoperative complications and length of stay (LOS) following ACDF with ERAS. The certainty of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Statistical analysis was performed using Review Manager 5.4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five studies involving 2330 patients (ERAS: 1108; conventional: 1222) were included. All studies demonstrated high methodological quality (NOS 7-9). Implementation of ERAS was associated with a significant reduction in length of stay (MD=-1.56; 95% CI: -1.83 to -1.28;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001; Moderate-certainty evidence) and a markedly lower incidence of postoperative nausea and vomiting(OR: 0.32; 95% CI: 0.15 to 0.68; P=0.03;High-certainty evidence). No significant differences were observed in overall complications(OR: 0.78; 95% CI: 0.37 to 1.63; Low-certainty evidence), hardware failure, surgical site infections, or dysphagia\/dysphonia (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05). Patient satisfaction showed a non-significant positive trend(OR: 1.31; 95% CI: 0.99 to 1.73; Low-certainty evidence).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Based on moderate-to-high certainty evidence, ERAS protocols significantly optimize perioperative recovery for ACDF by reducing hospital stay and gastrointestinal morbidity without compromising safety or patient satisfaction. These findings support the standardization and broader implementation of ERAS pathways in cervical spine surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261466189","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T19:03:22Z","timestamp":1785351802000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Enhanced Recovery after Surgery (ERAS) Reduces Hospital Stay and Postoperative Nausea in ACDF: A Meta-Analysis of 2330 Patients"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3654-1808","authenticated-orcid":false,"given":"Lei","family":"Peng","sequence":"first","affiliation":[{"name":"The Third Affiliated Hospital of Southern Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinliang","family":"Wei","sequence":"additional","affiliation":[{"name":"The Shenzhen Bao\u2019an District Songgang People\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Qin","sequence":"additional","affiliation":[{"name":"The Third Affiliated Hospital of Southern Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Zhao","sequence":"additional","affiliation":[{"name":"The Third Affiliated Hospital of Southern Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingchu","family":"Li","sequence":"additional","affiliation":[{"name":"The Third Affiliated Hospital of Southern Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/21925682251341812"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1227\/neu.0000000000003461"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000005348"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/21925682251338799"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000005387"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/wjs.12548"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.25270\/wmp.24025"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000040913"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-024-08533-x"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-024-02068-z"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/21925682251334058"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/bsd.0000000000001810"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2025.04.011"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2025.01.023"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2024.108350"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.17310"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2024.05.008"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/21925682241249105"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-023-08105-5"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j4008"},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-45"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjebm-2018-110962"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/cm9.0000000000002814"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1547"},{"key":"e_1_3_7_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1"},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","unstructured":"Shamseer L Moher D Clarke M et al. 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