Evidence map›Paper›PMID 42143193›Full record

ArticleSpine deformity2026

Suspected contaminant source and early deep wound infections in posterior instrumented fusion involving the lumbosacral region: a multicenter analysis.

Iryna Ivasyk, Devika A Shenoy, Lexie Z Yang, Bo Hu, Stephen Lewis, Eric Klineberg, Lawrence G Lenke, Justin S Smith, David Polly, Christopher Nielsen and 4 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Spine deformity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

14 authors.

Iryna IvasykDepartment of Orthopaedic Surgery, Duke University School of Medicine, 311 Trent Drive, Durham, NC, 27710, USA.
Devika A ShenoyDepartment of Orthopaedic Surgery, Duke University School of Medicine, 311 Trent Drive, Durham, NC, 27710, USA.ORCID http://orcid.org/0009-0006-7543-5414
Lexie Z YangDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
Bo HuDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
Stephen LewisDivision of Orthopaedic Surgery, University of Toronto, Toronto, Canada.
Eric KlinebergDepartment of Orthopedic Surgery, University of Texas, Houston, TX, USA.
Lawrence G LenkeDepartment of Orthopedic Surgery, Columbia University, New York, NY, USA.
Justin S SmithDepartment of Neurosurgery, University of Virginia, Charlottesville, VA, USA.
David PollyDepartment of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.
Christopher NielsenDivision of Orthopaedic Surgery, University of Toronto, Toronto, Canada.
Ronald A LehmanDepartment of Orthopedic Surgery, Columbia University, New York, NY, USA.
Zeeshan M SardarDepartment of Orthopedic Surgery, Columbia University, New York, NY, USA.
Christopher I ShaffreyDepartment of Neurosurgery, Duke University School of Medicine, Durham, NC, USA.
Brett RocosDepartment of Orthopaedic Surgery, Duke University School of Medicine, 311 Trent Drive, Durham, NC, 27710, USA. brett.rocos@duke.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeEarly deep wound infection complicates an estimated 4% of posterior lumbosacral fusions, increasing mortality and hospitalization costs. The objective of this study was to characterize causative organisms and risk factors of deep wound infections following spine surgery.

methodsRetrospective data were collected from six institutions regarding adults (> 18 years) who underwent posterior instrumented fusion crossing the lumbosacral junction between 2015 and 2022. Demographics, comorbidities, operative details, debridements, and microbiology results were recorded. Pathogens were grouped as "outside-in" (i.e., consistent with direct local contamination from feces or urine) or "inside-out" (i.e., consistent with hematogenous/surgical contamination). The interval from index procedure to debridement was compared between the two groups using multivariable linear regression with log transformation.

results99 patients met all study criteria. Intraoperative cultures isolated outside-in pathogens in 50 (51%) cases, inside-out pathogens in 33 (33%) cases, and negative cultures in 16 (16%) cases. Compared to inside-out infection, outside-in infection was associated with a 50% shorter time to debridement (95% CI [0.4, 0.6], p < 0.01). An index procedure involving five or more levels was associated with a 42% longer time to debridement (95% CI [1.0, 1.9], p = 0.03), while diabetes was associated with a 26% shorter time to debridement (95% CI [0.6, 0.9], p = 0.01).

conclusionOutside-in infections constituted a higher percentage of deep wound infections in comparison to inside-out infections and present earlier after lumbosacral surgery. Safety precautions and proper hygiene that limit enteric contamination should be encouraged in postoperative spinal fusion patients to reduce the risk of deep wound infection.

Indexed as

Lumbar VertebraeLumbosacral RegionSpinal FusionSurgical Wound InfectionAdultAgedDebridementFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsEnteric floraGram-negativeGram-positiveHygieneMicrobiologyPostoperative complicationsSpinal fusionSurgical wound infectionTreatment emergent infectionsWound care

Identifiers

PMID42143193

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