Shelby Hannah, Shelby Tara, Fresquez Zoe, Wang Jeffrey C, Hah Raymond
Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
Int J Spine Surg. 2025 Jun 12;19(3):296-301. doi: 10.14444/8724.
While studies have identified urinary tract infection (UTI) as a complication after spine fusion, UTI is understudied in the context of fusion for spinal deformity. This study sought to determine both UTI incidence after multilevel posterior fusion for spinal deformity and whether pooled risk factors (RFs) increased UTI risk.
Patients who had posterior fusion for spinal deformities between 2010 to 2019 were queried from the PearlDiver database, separated by the number of levels operated on (<7, 7-12, and >12), matched for age/gender, and analyzed for UTI incidence within 1 week and 1, 2, and 3 months. Any patient with a note of diabetes, obesity, rheumatoid arthritis, or coronary artery disease within 1-year prior to surgery and who contracted UTI within 1 month after fusion was included in the RF group for each level span. Patients of each level span with any RF were compared with those without any RFs. tests were used for statistical analyses.
A total of 20,893 patients underwent posterior fusion for spinal deformities from 2010 to 2019. After matching, each level set had 2239 patients. At 1, 2, and 3 months, the >12 levels subgroup showed statistically higher UTI incidence than the 7 to 12 and <7 levels subgroups. At 3 months, UTI was similar between the <7 and 7 to 12 subgroups, with 3.8% and 3.9%, respectively ( = 0.41), and UTI was statistically higher in the >12 subgroup at 4.6% (<7 vs 7-12: = 0.005; <7 vs >12: < 0.001). For each level group, the RF groups had significantly higher UTI rates at 1, 2, and 3 months. ORs were significantly greater than 1 for RF groups across all level subgroups (<7 OR = 2.8, < 0.001; 7-12 OR = 2.1, < 0.001; >12 OR = 2.3, < 0.001).
Diabetes, obesity, rheumatoid arthritis, and coronary artery disease were associated with a higher risk of UTI after posterior fusion for spinal deformity for all level sets. patients who underwent procedures for more than 12 levels had the highest rate of UTI. This is the first study to analyze and compare UTI incidence following fusion for spinal deformity.
虽然研究已将尿路感染（UTI）确定为脊柱融合术后的一种并发症，但在脊柱畸形融合的背景下，对UTI的研究较少。本研究旨在确定脊柱畸形多节段后路融合术后的UTI发生率，以及合并危险因素（RFs）是否会增加UTI风险。
从PearlDiver数据库中查询2010年至2019年间因脊柱畸形接受后路融合的患者，按手术节段数量（<7、7 - 12和>12）进行分组，匹配年龄/性别，并分析1周内以及1、2和3个月内的UTI发生率。在手术前1年内有糖尿病、肥胖、类风湿关节炎或冠状动脉疾病记录且在融合术后1个月内发生UTI的任何患者，被纳入每个节段跨度的RF组。将每个节段跨度有任何RF的患者与无任何RF的患者进行比较。采用检验进行统计分析。
2010年至2019年共有20893例患者因脊柱畸形接受后路融合。匹配后，每个节段组有2239例患者。在1、2和3个月时，>12节段亚组的UTI发生率在统计学上高于7至12节段和<7节段亚组。在3个月时，<7节段和7至12节段亚组的UTI发生率相似，分别为3.8%和3.9%（P = 0.41），而>12节段亚组的UTI发生率在统计学上更高，为4.6%（<7节段与7 - 12节段比较：P = 0.005；<7节段与>12节段比较：P < 0.001）。对于每个节段组，RF组在1、2和3个月时的UTI发生率显著更高。所有节段亚组中RF组的OR值均显著大于1（<7节段OR = 2.8，P < 0.001；7 - 12节段OR = 2.1，P < 0.001；>12节段OR = 2.3，P < 0.001）。
糖尿病、肥胖、类风湿关节炎和冠状动脉疾病与脊柱畸形后路融合术后UTI的较高风险相关，适用于所有节段组。接受超过12节段手术的患者UTI发生率最高。这是第一项分析和比较脊柱畸形融合术后UTI发生率的研究。
