Related Experiment Video
Updated: Jan 9, 2026
Novel Mini-open Transforaminal Lumbar Interbody Fusion
Published on: June 6, 2025
Modified subcutaneous lumbar spine index (MSLSI): a new predictor for early surgical site infection after
Xu Shen1, Chen Yao1, Jiahua Duan1
1Department of Joint Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Purpose:
The purpose of this study is to explore the value of Modified subcutaneous lumbar spine index (MSLSI) as a new predictor for early surgical site infection (SSI) after transforaminal lumbar interbody fusion (TLIF).
Methods:
We conducted a retrospective case-control study involving patients who underwent TLIF between 2015 and 2021 at our hospital. Thirty-one patients with early postoperative SSI were enrolled in cases group, and the controls were matched (1:2) using the following criteria: gender (female/male), age (±3 y), diabetes (insulin/oral/no), date of surgery (morning/afternoon) and season of surgery (spring/summer/autumn/winter). MSLSI was measured on mid-sagittal T2-weighted MRI imaging. Pearson correlation analysis was calculated to evaluate the relationship between MSLSI and BMI. The Receiver Operating Characteristic (ROC) curve was performed to evaluate the value of MSLSI and subcutaneous fat thickness in predicting the early SSI following TLIF. The radiographic parameters were measured independently by two doctors using the Picture Archiving Communication System (PACS).
Results:
Ninety-three patients were enrolled in final analysis, with 31 cases in SSI group and 62 matched controls. Univariate and multivariate logistic regression analysis indicated that SSI were significantly correlated with obesity (OR = 6.43, 95%CI = 1.16-35.73, p = 0.033), subcutaneous fat thickness (OR = 4.53, 95%CI =1.32-15.52, p = 0.016) and MSLSI (OR = 6.17, 95%CI = 1.73-22.12, p = 0.005). The ROC curve demonstrated that the risk of early SSI development increased when the MSLSI was ≥0.68. Pearson correlation analysis indicated that MSLSI was moderate correlation with body mass index (BMI).
Conclusion:
MSLSI represents an innovative radiographic index that independently predicts early SSI risk after TLIF.
Insights
The Modified subcutaneous lumbar spine index (MSLSI) can predict early surgical site infections (SSI) after transforaminal lumbar interbody fusion (TLIF). An MSLSI of 0.68 or higher indicates an increased risk of SSI development.
Area of Science:
- Spine surgery
- Radiology
- Infectious disease
Background:
- Surgical site infection (SSI) is a significant complication after transforaminal lumbar interbody fusion (TLIF).
- Early prediction of SSI risk is crucial for patient management and outcomes.
- Novel imaging biomarkers are needed to identify patients at higher risk.
Purpose of the Study:
- To evaluate the Modified subcutaneous lumbar spine index (MSLSI) as a novel predictor for early SSI following TLIF.
- To assess the correlation between MSLSI and Body Mass Index (BMI).
- To compare the predictive value of MSLSI against subcutaneous fat thickness for SSI.
Main Methods:
- Retrospective case-control study of 93 patients undergoing TLIF (2015-2021).
- Cases (31) had early SSI, controls (62) were matched by demographics and surgery details.
- MSLSI measured on T2-weighted MRI; correlation and ROC curve analyses performed.
Main Results:
- SSI was significantly correlated with obesity (OR=6.43), subcutaneous fat thickness (OR=4.53), and MSLSI (OR=6.17).
- MSLSI showed a moderate correlation with BMI.
- ROC analysis indicated that MSLSI ≥0.68 predicts increased early SSI risk.
Conclusions:
- MSLSI is an independent predictor of early SSI risk after TLIF.
- This novel radiographic index offers valuable insights for preoperative risk assessment.
- MSLSI may aid in identifying patients requiring closer monitoring or preventative strategies.
