What question did this study set out to answer?

This research aims to identify risk factors for surgical site infection in patients with degenerative lumbar spine disease undergoing PLIF.

March 8, 2026Open Access

Risk factors for surgical site infection following posterior lumbar interbody fusion in patients with degenerative lumbar spine disease: a retrospective study

Key Points

This research aims to identify risk factors for surgical site infection in patients with degenerative lumbar spine disease undergoing PLIF.
Conducted a retrospective analysis of 180 patients who underwent PLIF.
Categorized patients into surgical site infection (SSI) and non-SSI groups.
Collected data on demographics, BMI, operative details, and various indices.
Performed univariate and multivariate logistic regression analyses to identify SSI predictors.
Higher BMI, greater lumbar vertical distance from skin to spinous process, and prolonged operative time were identified as independent risk factors for SSI.
Lower psoas major and paraspinal muscle indices were also associated with increased SSI risk.
All identified risk factors had statistically significant predictive value (p < 0.05).

Abstract

To identify risk factors for surgical site infection (SSI) in patients with degenerative lumbar spine disease undergoing posterior lumbar interbody fusion (PLIF) and to evaluate their independent predictive value to inform perioperative infection prevention strategies. A retrospective analysis was conducted on 180 patients who underwent PLIF at the Third Hospital of Hebei Medical University between January 2022 and July 2024. Patients were categorized into SSI (n = 60) and non-SSI (n = 120) groups. Collected data included demographics, body mass index (BMI), hypertension, diabetes, American Society of Anesthesiologists classification, lumbar vertical distance from skin to spinous process, psoas major index, multifidus index, paraspinal muscle index, number of surgical segments, operative time, intraoperative blood loss, use of allogeneic bone, postoperative cerebrospinal fluid leakage, drainage duration, preoperative leukocyte count, and serum albumin levels. Univariate analyses were performed, followed by multivariate logistic regression to identify independent predictors of SSI. Univariate analysis indicated significant differences between the SSI and non-SSI groups in BMI, lumbar vertical distance from skin to spinous process, psoas major index, paraspinal muscle index, and operative time (p 0.05). Multivariate logistic regression identified higher BMI, greater lumbar vertical distance from skin to spinous process, lower psoas major and paraspinal muscle indices, and prolonged operative time as independent risk factors for SSI (all p < 0.05). Increased BMI, greater lumbar vertical distance from skin to spinous process, reduced psoas major and paraspinal muscle indices, and extended operative duration independently predict SSI following PLIF. Addressing these factors through targeted perioperative management strategies may reduce infection rates and improve surgical outcomes.

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