BACKGROUND The aim of this study was to investigate the correlation between lumbar multifidus fat infiltration and lumbar postoperative surgical site infection (SSI). Several clinical studies have found that spine postoperative SSI is associated with age, diabetes, obesity, and multilevel surgery. However, few studies have focused on the correlation between lumbar multifidus fat infiltration and SSI. METHOD A retrospective review was performed on patients who underwent posterior lumbar interbody fusion (PLIF) between 2011 and 2016 at our hospital. The patients were divided into SSI and non-SSI groups. Data of risk factors [age, diabetes, obesity, body mass index (BMI), number of levels, and surgery duration] and indicators of body mass distribution (subcutaneous fat thickness and multifidus fat infiltration) were collected. The degree of multifidus fat infiltration was analyzed on magnetic resonance images using Image J. RESULTS Univariate analysis indicated that lumbar spine postoperative SSI was associated with urinary tract infection, subcutaneous fat thickness, lumbar multifidus muscle (LMM) fat infiltration, multilevel surgery (≥2 levels), surgery duration, drainage duration, and number of drainage tubes. In addition, multiple logistic regression analysis revealed that spine SSI development was associated with sex (male), age (> 60 years), subcutaneous fat thickness, LMM fat infiltration, and drainage duration. Receiver operating characteristic curve analysis indicated that the risk of SSI development was higher when the percentage of LMM fat infiltration exceeded 29.29%. Furthermore, Pearson's correlation analysis demonstrated that LMM fat infiltration was correlated with age but not with BMI. CONCLUSION Indicators of body mass distribution may better predict SSI risk than BMI following PLIF. Lumbar Multifidus fat infiltration is a novel spine-specific risk factor for SSI development.

中文翻译：

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腰椎多裂处脂肪浸润与腰椎术后感染的相关性：一项回顾性病例对照研究。

背景技术这项研究的目的是研究腰椎多发性脂肪浸润与腰椎术后手术部位感染（SSI）之间的相关性。几项临床研究发现，脊柱术后SSI与年龄，糖尿病，肥胖症和多层次手术有关。但是，很少有研究集中在腰椎多裂处脂肪浸润与SSI之间的相关性。方法回顾性分析2011年至2016年间在我院接受腰椎后路椎体间融合术（PLIF）的患者。将患者分为SSI组和非SSI组。收集危险因素[年龄，糖尿病，肥胖，体重指数（BMI），水平数和手术持续时间]的数据以及体重分布指标（皮下脂肪厚度和多发性脂肪浸润）。结果在磁共振图像上使用Image J分析了多裂口脂肪的浸润程度。结果单因素分析表明，腰椎术后SSI与尿路感染，皮下脂肪厚度，腰部多裂肌（LMM）脂肪浸润，多级手术有关（≥2水平），手术时间，引流时间和引流管数量。此外，多项逻辑回归分析显示，脊柱SSI的发展与性别（男性），年龄（> 60岁），皮下脂肪厚度，LMM脂肪浸润和引流时间有关。受试者工作特征曲线分析表明，当LMM脂肪浸润百分比超过29.29％时，发生SSI的风险更高。此外，皮尔逊 相关分析表明，LMM脂肪浸润与年龄相关，而与BMI不相关。结论在PLIF后，体重分布指标比BMI更好地预测SSI风险。腰椎多发性脂肪浸润是SSI发生的新型脊柱特异性危险因素。