Development of a risk scoring system for surgical site infection after lumbar surgery using Dixon MRI and clinical parameters.

IF 2.7 3区医学 Q2 CLINICAL NEUROLOGY

European Spine Journal Pub Date : 2025-10-01 Epub Date: 2025-06-05 DOI:10.1007/s00586-025-08971-1

Yijin Wang, Qiyang Wang, Huayan Zuo, Xiarong Gong, Yong Yang, Guoli Bi, Qiu Bi

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引用次数: 0

Abstract

Objective: To devise a scoring model that integrates clinical parameters and Dixon MRI markers to predict the probability of surgical site infections (SSI) occurrence after lumbar surgery.

Methods: A retrospective analysis was conducted on 1307 patients who underwent lumbar surgery, with 63 SSI patients and 1244 non-SSI patients. Clinical characteristics and the quantitative parameters on Dixon MRI, such as fat fraction (FF), functional cross-sectional area (FCSA), and psoas to lumbar vertebral index (PLVI), were assessed for differences between the two groups. A multivariate logistic regression model was applied to identify independent predictors that could be utilized in developing of a scoring system, and the performance was assessed through the receiver operating characteristic (ROC) curve.

Results: The incidence of SSI was 4.82% (63/1307). The preoperative risk factors for SSI included age (OR 4.442, P = 0.049), duration of surgery (OR 2.872, P = 0.029), multi-segment surgery (OR 3.463, P = 0.021), surgical approach (OR 8.223, P = 0.045), and FCSA (OR 2.152, P = 0.004). When the overall scores of these five predictors were greater than or equal to 3.5 points, the area under the curve (AUC) was 0.823, with sensitivity, specificity, positive predictive value, and negative predictive value of 56.6%, 91.9%, 26.1%, and 97.7%, respectively.

Conclusion: The scoring system based on clinical parameters and Dixon MRI indicators is promising for predicting post-lumbar surgery SSI.

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利用Dixon MRI和临床参数建立腰椎手术后手术部位感染风险评分系统。

目的：设计一种综合临床参数和Dixon MRI标记物的评分模型，预测腰椎手术后手术部位感染（SSI）发生的概率。方法：对1307例腰椎手术患者进行回顾性分析，其中SSI患者63例，非SSI患者1244例。评估两组患者的临床特征和Dixon MRI定量参数，如脂肪分数（FF）、功能横截面积（FCSA）、腰肌腰椎指数（PLVI）。采用多变量logistic回归模型确定独立预测因子，并通过受试者工作特征（ROC）曲线对其进行评价。结果：SSI发生率为4.82%（63/1307）。SSI的术前危险因素包括年龄（OR 4.442, P = 0.049）、手术时间（OR 2.872, P = 0.029）、多节段手术（OR 3.463, P = 0.021）、手术入路（OR 8.223, P = 0.045）、FCSA （OR 2.152, P = 0.004）。当5项预测指标总分大于等于3.5分时，曲线下面积（AUC）为0.823，敏感性56.6%，特异性91.9%，阳性预测值26.1%，阴性预测值97.7%。结论：基于临床参数和Dixon MRI指标的评分系统有望预测腰椎术后SSI。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Spine Journal 医学-临床神经学

CiteScore

4.80

自引率

10.70%

发文量

373

审稿时长

2-4 weeks

期刊介绍： "European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts. Official publication of EUROSPINE, The Spine Society of Europe