Evidence map›Paper›PMID 40935588›Full record

ArticleInternational journal of spine surgery2025

Incidental Durotomy Significantly Increases the Risk of Postoperative Infection Following Lumbar Spine Surgery for Degenerative Conditions: A Systematic Review and Meta-analysis.

Tamara Babasiz, Jannik Leyendecker, Maximilian Weber, Philipp Egenolf, Jürgen Hampl, Ayla Yagdiran, Peer Eysel, Krishnan Sircar

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In one paragraph

Article in International journal of spine surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

8 authors.

Tamara BabasizFaculty of Medicine and University Hospital Cologne, Department of Orthopedic and Trauma Surgery, University of Cologne, Köln, Germany Tamara.Babasiz@uk-koeln.de.
Jannik LeyendeckerFaculty of Medicine and University Hospital Cologne, Department of Orthopedic and Trauma Surgery, University of Cologne, Köln, Germany.
Maximilian WeberFaculty of Medicine and University Hospital Cologne, Department of Orthopedic and Trauma Surgery, University of Cologne, Köln, Germany.
Philipp EgenolfFaculty of Medicine and University Hospital Cologne, Department of Orthopedic and Trauma Surgery, University of Cologne, Köln, Germany.
Jürgen HamplFaculty of Medicine and University Hospital Cologne, Department of Neurosurgery, University of Cologne, Köln, Germany.
Ayla YagdiranFaculty of Medicine and University Hospital Cologne, Department of Orthopedic and Trauma Surgery, University of Cologne, Köln, Germany.
Peer EyselFaculty of Medicine and University Hospital Cologne, Department of Orthopedic and Trauma Surgery, University of Cologne, Köln, Germany.
Krishnan SircarFaculty of Medicine and University Hospital Cologne, Department of Orthopedic and Trauma Surgery, University of Cologne, Köln, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccidental dural tear (ADT), an unintended intraoperative breach of the dura mater, is a recognized complication in lumbar spine surgery for degenerative conditions. Postoperative surgical site infections are serious adverse outcomes in this context. However, the role of ADT in increasing postoperative infection risk remains insufficiently defined. This systematic review and meta-analysis aimed to comprehensively assess the association between ADT and the occurrence of postoperative infection.

methodsA systematic literature search was performed in PubMed, ScienceDirect, and CENTRAL from inception to 6 August 2024. Studies involving degenerative lumbar surgery and reporting data on both incidental durotomy and postoperative infections were included. Study quality, including risk of bias analysis, was appraised by 2 independent observers. Subsequently, 2 meta-analyses were conducted, estimating the pooled incidence of infection among patients with ADT and another calculating pooled odds ratios to evaluate infection risk.

resultsFourteen studies comprising 376,164 patients met the inclusion criteria. The incidence of ADT ranged from 1.9% to 11.8%, with higher rates observed in revision surgeries. Key risk factors included obesity, diabetes, revision surgery, advanced age, and extended operative time. The meta-analysis comprised 7 studies, including 7500 patients with dural tears and 189,058 patients without dural tears. The pooled incidence of postoperative infection among patients with ADT was 13.1% (95% CI: 6.8%-23.8%), which was significantly higher compared with 5.4% (95% CI: 3.1%-7.5%) among patients without ADT (

conclusionADTs during lumbar spine surgery for degenerative conditions are associated with a significantly increased risk of postoperative infections. Although this relationship is multifactorial, affected by surgical complexity and patient comorbidities, these findings underscore the importance of heightened vigilance in infection prevention and control following ADT to reduce infection-related morbidity. CLINICAL RELEVANCE: Incidental dural tear during lumbar spine surgery for degenerative conditions significantly increases the risk for postoperative infection and should be a focus of preventive strategies. LEVEL OF EVIDENCE: 1:

Indexed as

accidental dural tearcomplicationincidental durotomyinfectionlumbar spinespinal surgery

Identifiers

PMID40935588
PMCPMC12800642

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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.