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Research ArticleLumbar Spine

Subcutaneous Fat Thickness on Erect Radiographs Is a Predictor of Infection Following Elective Posterior Lumbar Fusion

Khalid AlSaleh, Abdulrahman Aldowesh, Muteb Alqhtani, Musab Alageel, Abdulmajeed AlZakri, Osama Alrehaili and Waleed Awwad
International Journal of Spine Surgery August 2022, 16 (4) 660-665; DOI: https://doi.org/10.14444/8295
Khalid AlSaleh
1 Department of Orthopedics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
FRCSC
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Abdulrahman Aldowesh
2 Department of orthopedics, King Saud Medical City, Riyadh, Saudi Arabia
MBBS
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Muteb Alqhtani
1 Department of Orthopedics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
MBBS
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Musab Alageel
1 Department of Orthopedics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
MBBS
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Abdulmajeed AlZakri
1 Department of Orthopedics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
MD, MS
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Osama Alrehaili
1 Department of Orthopedics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
MD
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Waleed Awwad
1 Department of Orthopedics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
FRCSC
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    Figure 1

    Skin to spinous process measurements at L4 on x-ray imaging and magnetic resonance imaging.

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    Figure 2

    Scatter plot showing linear relationship between BMI and “skin to spinous process” measurements. BMI, body mass index.

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    Table 1

    Demographics and clinical data (N = 366).

    Risk FactorSurgical Site Infection CohortControl Group P Value
    Age, y, mean (SD)48.2 (19.0)50.1 (19.7)0.722
    Female sex, n (%)21 (81)21 (81)1.00
    Body mass index, mean (SD)33.4 (9.1)28.9 (6.9)0.049
    No. of levels, mean (SD)4.1 (4.4)3.5 (4.3)0.632
    Length of anesthesia, min, mean (SD)334 (119)354 (124)0.552
    Estimated blood loss, mL, mean (SD)571 (459)400 (265)0.106
    Serum glucose on day 3, mmol/L, mean (SD)8.58 (3.5)7.49 (1.9)0.168
    Drain use, n (%)13 (50)14 (54)0.781
    Days from initial procedure to reoperation, mean (SD)21.7 (14.6)N/AN/A
    Skin to SP on x-ray, mm, mean (SD)47.9 (14.9)37.7 (17.1)0.017
    Skin to SP on sagittal MRI, mm, mean (SD)43.5 (14.9)35.0 (17.1)0.062
    Skin to SP on axial MRI, mm, mean (SD)39.3 (14.2)34.3 (16.1)0.248
    Skin to lamina on MRI, mm, mean (SD)61.2 (16.7)55.4 (16.5)0.213
    • Abbreviations: MRI, magnetic resonance imaging; SP, spinous process.

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    Table 2

    Multiple regression analysis of risk factors for surgical site infection.

    Risk FactorOR95% CI P Value
    Body mass index1.1141.020–1.2170.016
    Skin to SP on x-ray imaging1.0771.021–1.1350.006
    Skin to SP on sagittal magnetic resonance imaging1.0571.009–1.1070.020
    • Abbreviation: SP, spinous process.

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International Journal of Spine Surgery
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1 Aug 2022
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Subcutaneous Fat Thickness on Erect Radiographs Is a Predictor of Infection Following Elective Posterior Lumbar Fusion
Khalid AlSaleh, Abdulrahman Aldowesh, Muteb Alqhtani, Musab Alageel, Abdulmajeed AlZakri, Osama Alrehaili, Waleed Awwad
International Journal of Spine Surgery Aug 2022, 16 (4) 660-665; DOI: 10.14444/8295

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Subcutaneous Fat Thickness on Erect Radiographs Is a Predictor of Infection Following Elective Posterior Lumbar Fusion
Khalid AlSaleh, Abdulrahman Aldowesh, Muteb Alqhtani, Musab Alageel, Abdulmajeed AlZakri, Osama Alrehaili, Waleed Awwad
International Journal of Spine Surgery Aug 2022, 16 (4) 660-665; DOI: 10.14444/8295
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