• Zhonghai Li, Peng Liu, Chunli Zhang, Gang Xu, Yu Zhang, Yvang Chang, Mozhen Liu, and Shuxun Hou.
• Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China; Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Liaoning Province, People's Republic of China. Electronic address: lizhonghaispine@126.com.
• World Neurosurg. 2019 Nov 1; 131: e460-e467.

PurposeSurgical site infection (SSI) in spine surgery remains a significant cause of morbidity and prolonged hospitalization. We intended to document our experience in our center and to highlight possible factors influencing SSI in posterior lumbar fusion surgery.MethodsBetween June 2015 and March 2017, 448 consecutive patients with lumbar degenerative disease who underwent classic open transforaminal lumbar interbody fusion were enrolled in the study. We divided the patients into the SSI group and the non-SSI group and compared their patient-specific and procedure-specific factors. Univariate and multiple logistic regression analyses were performed to determine risk factors.ResultsThere was a significant difference between groups in age (P = 0.001), body mass index (P < 0.001), subcutaneous fat thickness (P < 0.001), preoperative American Society of Anesthesiologists (ASA) score (P < 0.001), postoperative hemoglobin (P = 0.003), preoperative serum albumin (P < 0.001), operative time (P < 0.001), operated levels (P < 0.001), postoperative drainage (P = 0.004), time of draining (P < 0.001) and late-presenting dural tear (P = 0.008). Logistic regression analysis of these differences showed that thicker subcutaneous fat thickness, higher preoperative ASA score, lower preoperative serum albumin, and longer time of draining were significantly related to SSI (P < 0.05).ConclusionsThe risk factors for SSI after lumbar fusion surgery are multifactorial. These data should provide a step toward the development of quality improvement measures aimed at reducing complications in high-risk patients. These factors may prove useful for patient counseling and for surgical planning.Copyright © 2019 Elsevier Inc. All rights reserved.

36 keywords...

hide…