{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T06:00:15Z","timestamp":1785218415639,"version":"3.55.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Scoliosis correction surgery is associated with significant perioperative morbidity and prolonged recovery. Enhanced Recovery After Surgery (ERAS) protocols, which employ evidence-based, multimodal perioperative care, have been increasingly used in spinal surgery to improve patient outcomes. However, their efficacy and safety in scoliosis correction surgery remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This protocol describes a systematic review and meta-analysis following PRISMA-P guidelines. We will systematically search electronic databases from inception to January 2026 for randomized controlled trials and observational studies comparing ERAS protocols with conventional care in patients undergoing scoliosis correction surgery. The primary outcome will be length of hospital stay. Secondary outcomes will include postoperative complications, pain intensity, opioid consumption, time to ambulation, readmission rates, patient satisfaction, healthcare costs, and adverse events. Two independent reviewers will screen studies, extract data, and assess methodological quality using the Cochrane Risk of Bias tool version 2 for randomized trials and the Risk of Bias in Non-randomized Studies - of Interventions tool for non-randomized studies. Meta-analysis will be performed using Review Manager version 5.4 and Stata version 17 when feasible. The certainty of evidence will be assessed using the GRADE approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis will synthesize current evidence on the effectiveness and safety of ERAS protocols in scoliosis correction surgery. The findings are expected to inform clinical practice, support guideline development, and highlight gaps for future research. Results will be disseminated via peer-reviewed publication and scientific meetings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>PROSPERO, CRD420251089411<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1872301","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T05:35:32Z","timestamp":1785216932000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Enhanced recovery after surgery in patients undergoing scoliosis correction surgery: protocol for a systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Jixin","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Shaoxing Shangyu District Hospital of Traditional Chinese Medicine","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinxin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shaoxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huahai","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shaoxing Shangyu District Hospital of Traditional Chinese Medicine","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiafeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shaoxing Shangyu District Hospital of Traditional Chinese Medicine","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shaoxing Shangyu District Hospital of Traditional Chinese Medicine","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianliang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shaoxing Shangyu District Hospital of Traditional Chinese Medicine","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ci","family":"Wang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shaoxing Shangyu District Hospital of Traditional Chinese Medicine","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"101116","DOI":"10.1016\/j.accpm.2022.101116","article-title":"Enhanced recovery after surgery (ERAS) for adolescent idiopathic scoliosis: standardisation of care improves patient outcomes","volume":"41","author":"Pico","year":"2022","journal-title":"Anaesth Crit Care Pain Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e224","DOI":"10.1016\/j.wneu.2020.10.009","article-title":"An optimized enhanced recovery after surgery (ERAS) pathway improved patient care in adolescent idiopathic scoliosis surgery: a retrospective cohort study","volume":"145","author":"Yang","year":"2021","journal-title":"World Neurosurg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"3723","DOI":"10.3390\/ijms26083723","article-title":"Clinical outcomes and inflammatory response to the enhanced recovery after surgery (ERAS) protocol in adolescent idiopathic scoliosis surgery: an observational study","volume":"26","author":"Salamanna","year":"2025","journal-title":"Int J Mol Sci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1068","DOI":"10.1111\/pan.13988","article-title":"Enhanced recovery after surgical correction of adolescent idiopathic scoliosis","volume":"30","author":"Julien-Marsollier","year":"2020","journal-title":"Pediatr Anesth"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1588","DOI":"10.1016\/j.spinee.2025.01.023","article-title":"Benefits of early recovery after surgery (ERAS) protocols on perioperative outcomes in patients undergoing elective lumbar spinal fusion: a prospective study","volume":"25","author":"Yao","year":"2025","journal-title":"Spine J"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"E6","DOI":"10.3171\/2019.1.FOCUS18669","article-title":"Benefits of enhanced recovery after surgery for fusion in degenerative spine surgery: impact on outcome, length of stay, and patient satisfaction","volume":"46","author":"Debono","year":"2019","journal-title":"Neurosurg Focus"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.bpa.2014.03.001","article-title":"Multimodal therapy in perioperative analgesia","volume":"28","author":"Gritsenko","year":"2014","journal-title":"Best Pract Res Clin Anaesthesiol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"E3","DOI":"10.3171\/2019.1.FOCUS18700","article-title":"Enhanced recovery after spine surgery: a systematic review","volume":"46","author":"Elsarrag","year":"2019","journal-title":"Neurosurg Focus"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1544","DOI":"10.1177\/21925682241249105","article-title":"The impact of peri-operative enhanced recovery after surgery protocols on outcomes following adult cervical deformity surgery","volume":"15","author":"Tretiakov","year":"2025","journal-title":"Glob Spine J"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1007\/s43390-021-00310-w","article-title":"Enhanced recovery after surgery (ERAS) in adolescent idiopathic scoliosis (AIS): a meta-analysis and systematic review","volume":"9","author":"Gadiya","year":"2021","journal-title":"Spine Deform"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1007\/s43390-025-01040-z","article-title":"Enhanced recovery after surgery for adolescent idiopathic scoliosis: a revised systematic review and meta-analysis","volume":"13","author":"Brigato","year":"2025","journal-title":"Spine Deform"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"23","DOI":"10.4103\/ija.ija_953_24","article-title":"Impact of enhanced recovery after surgery (ERAS) protocols in idiopathic scoliosis of children: a systematic review with meta-analysis and trial sequential analysis","volume":"69","author":"Sarkar","year":"2025","journal-title":"Indian J Anaesth"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"3457","DOI":"10.1007\/s00586-021-06984-0","article-title":"Comparison of interventions and outcomes of enhanced recovery after surgery: a systematic review and meta-analysis of 2456 adolescent idiopathic scoliosis cases","volume":"30","author":"Koucheki","year":"2021","journal-title":"Eur Spine J"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"103626","DOI":"10.1016\/j.otsr.2023.103626","article-title":"Enhanced recovery following posterior spinal fusion for adolescent idiopathic scoliosis: a medical and economic study in a French private nonprofit pediatric hospital","volume":"109","author":"Jeandel","year":"2023","journal-title":"Orthop Traumatol Surg Res"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1007\/s43390-024-01032-5","article-title":"Longitudinal impact of a perioperative pathway for spinal fusion in adolescent idiopathic scoliosis: a quality improvement project","volume":"13","author":"Floccari","year":"2025","journal-title":"Spine Deform"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1007\/s00586-019-06133-8","article-title":"Opioid-sparing multimodal analgesia with bilateral bi-level erector spinae plane blocks in scoliosis surgery: a case report of two patients","volume":"29","author":"Chin","year":"2020","journal-title":"Eur Spine J"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e20151568","DOI":"10.1542\/peds.2015-1568","article-title":"Rapid recovery pathway after spinal fusion for idiopathic scoliosis","volume":"137","author":"Muhly","year":"2016","journal-title":"Pediatrics"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2277","DOI":"10.1111\/pme.12751","article-title":"The incidence and severity of postoperative pain following inpatient surgery","volume":"16","author":"Buvanendran","year":"2015","journal-title":"Pain Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1093\/ejcts\/ezy301","article-title":"Guidelines for enhanced recovery after lung surgery: recommendations of the enhanced recovery after surgery (ERAS\u00ae) society and the European society of thoracic surgeons (ESTS)","volume":"55","author":"Batchelor","year":"2019","journal-title":"Eur J Cardiothorac Surg"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1001\/jamasurg.2016.4952","article-title":"Enhanced recovery after surgery: a review","volume":"152","author":"Ljungqvist","year":"2017","journal-title":"JAMA Surg"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: an emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1002\/9781119536604.ch14","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Sch\u00fcnemann","year":"2019"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/j.jclinepi.2010.07.015","article-title":"GRADE guidelines: 3. Rating the quality of evidence","volume":"64","author":"Balshem","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","author":"Page","year":"2021","journal-title":"BMJ"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1872301\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T05:35:33Z","timestamp":1785216933000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1872301\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":25,"alternative-id":["10.3389\/fmed.2026.1872301"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1872301","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"article-number":"1872301"}}