• Ankit I Mehta, Ranjith Babu, Isaac O Karikari, Betsy Grunch, Vijay J Agarwal, Timothy R Owens, Allan H Friedman, Carlos A Bagley, and Oren N Gottfried.
• Division of Neurosurgery, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA. ankit.mehta@duke.edu
• Spine. 2012 Sep 1;37(19):1652-6.

Study DesignA retrospective review.ObjectiveThe purpose of this study was to determine the role in body habitus and weight distribution on developing a surgical site infection (SSI).Summary Of Background DataSSI after lumbar spine surgery remains a significant cause of morbidity. The literature demonstrates an increased risk of postoperative infections associated with obesity, diabetes, and multilevel surgeries.MethodsA retrospective review was performed on a consecutive cohort of 298 adult patients who underwent lumbar spine fusion surgeries between 2006 and 2008 at the Duke University Medical Center. Previously identified risk factors (i.e., number of levels, diabetes, body mass index [BMI]) were collected, as well as the horizontal distance from the lamina to the skin surface (measured at L4) and thickness of subcutaneous fat at the surgical site.ResultsAmong the 298 patients, 24 (8%) had postoperative infections. Of the previously identified risk factors, number of levels (P = 0.0078) was found to be significantly associated with infections, whereas BMI (P = 0.16) and diabetes (P = 0.13) were found not to be statistically significant. Obesity (BMI ≥30) (P = 0.025), skin to lamina distance (P = 0.046), and thickness of the subcutaneous fat (P = 0.035) were found to be significant risk factors for SSI.ConclusionOur findings suggest that in obese patients, the distribution of body mass is more predictive of SSI than the absolute BMI and deserves attention in preoperative evaluation.

31 keywords...

hide…