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The authors of the Letter to the Editor regarding our study titled "The influence of cognitive-behavioral therapy on lumbar spine surgery outcomes: a systematic review and meta-analysis" are kindly thanked for their insight in elucidating several important considerations to our manuscript. In general, when choosing between a fixed-effects model and random effects model, prior researchers have argued the decision should be based on whether intervention effects are identical - with preference given to a random-effects model when this assumption is unlikely [[3]]. Response to the Letter to the Editor of X. Zhou et al. concerning "the influence of cognitive behavioral therapy on lumbar spine surgery outcomes: a systematic review and meta-analysis" by Parish JM, et al. (Eur Spine J [2021]; 30(5):1365-1379). [Extracted from the article]