Incidence and clinical associations of in-hospital bacterial meningitis after cervical spine fusion: a nationwide inpatient sample analysis
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: In-hospital bacterial meningitis following cervical spine fusion is an uncommon but potentially devastating complication. Due to its rarity, limited data exist regarding its incidence, associated clinical factors, and impact on hospitalization outcomes. This study aimed to characterize the incidence, clinical associations, and outcomes of bacterial meningitis occurring during the index hospitalization following elective cervical spine fusion using a large national database. Methods: A retrospective cross-sectional analysis of patients aged ≥18 years who underwent elective cervical spinal fusion between 2002 and 2014 was performed using the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS). Cervical fusion procedures were identified using International Classification of Diseases (ICD)-9-CM procedure codes for anterior (81.02) and posterior (81.03) cervical fusion. In-hospital postoperative bacterial meningitis was identified using ICD-9 diagnosis codes (320.0-320.9) recorded during the index admission. Postoperative cerebrospinal fluid (CSF) leak was identified using ICD-9 diagnosis codes for dural tear and CSF-related complications. Patient characteristics, CSF leak status, surgical approach, length of stay (LOS), hospital charges, and mortality were analyzed. Given the extremely low event rate, regression analyses were considered exploratory and interpreted cautiously. Results: 0.1%]. Conclusions: Bacterial meningitis following cervical spine fusion during the index hospitalization is exceedingly rare but associated with substantial morbidity. A postoperative CSF leak was strongly associated with meningitis occurrence, particularly among patients undergoing posterior cervical fusion. These findings support heightened clinical awareness and early diagnostic evaluation in patients who develop CSF leakage after cervical fusion. Further studies are needed to validate these associations and determine preventive strategies.
Source: Journal of Spine Surgery
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7221770646