Ruffilli Alberto, Manzetti Marco, Cerasoli Tosca, Barile Francesca, Viroli Giovanni, Traversari Matteo, Salamanna Francesca, Fini Milena, Faldini Cesare
1st Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.
Complex Structure Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.
Microorganisms. 2022 Sep 26;10(10):1905. doi: 10.3390/microorganisms10101905.
Surgical site infection (SSI) is a feared complication in spinal surgery, that leads to lower outcomes and increased healthcare costs. Among its risk factors, sarcopenia and osteopenia have recently attracted particular interest. The purpose of this article is to evaluate the influence of sarcopenia and osteopenia on the postoperative infection rate in patients treated with posterior fusion for degenerative diseases of the lumbar spine. This retrospective study included data from 308 patients. Charts were reviewed and central sarcopenia and osteopenia were evaluated through magnetic resonance images (MRI), measuring the psoas to lumbar vertebral index (PLVI) and the M score. Multivariate linear regression was performed to identify independent risk factors for infection. The postoperative SSI rate was 8.4%. Patients with low PLVI scores were not more likely to experience postoperative SSI ( = 0.68), while low M-score patients were at higher risk of developing SSI ( = 0.04). However, they did not generally show low PLVI values ( = 0.5) and were homogeneously distributed between low and high PLVI ( = 0.6). Multivariate analysis confirmed a low M score to be an independent risk factor for SSI ( = 0.01). Our results suggest that osteopenia could have significant impact on spinal surgery, and prospective studies are needed to better investigate its role.
手术部位感染（SSI）是脊柱手术中令人担忧的并发症，会导致预后变差和医疗费用增加。在其风险因素中，肌肉减少症和骨质减少症最近引起了特别关注。本文旨在评估肌肉减少症和骨质减少症对腰椎退行性疾病后路融合术患者术后感染率的影响。这项回顾性研究纳入了308例患者的数据。查阅病历，并通过磁共振成像（MRI）评估中枢性肌肉减少症和骨质减少症，测量腰大肌与腰椎指数（PLVI）和M评分。进行多变量线性回归以确定感染的独立危险因素。术后SSI发生率为8.4%。PLVI评分低的患者术后发生SSI的可能性并不更高（P = 0.68），而M评分低的患者发生SSI的风险更高（P = 0.04）。然而，他们一般未表现出低PLVI值（P = 0.5），且在低PLVI和高PLVI之间均匀分布（P = 0.6）。多变量分析证实低M评分是SSI的独立危险因素（P = 0.01）。我们的结果表明，骨质减少症可能对脊柱手术有重大影响，需要进行前瞻性研究以更好地探究其作用。
