Diabetes mellitus as a risk factor for infection after posterior lumbar arthrodesis: multivariate analysis of 356...

Lumbar spinal fusion is a widely used technique in the treatment of conditions such as lumbar stenosis and degenerative spondylolisthesis. However, acute postoperative infection remains a significant complication. The aim of this study was to identify risk factors associated with a higher incidence of acute infection following posterior lumbar fusion for degenerative pathology.

We conducted an observational, retrospective, and analytical study at a single hospital center. Patients over 18years of age who underwent instrumented lumbar fusion for lumbar stenosis or degenerative spondylolisthesis between 2017 and 2022 were included. Demographic, clinical, and surgical variables were analyzed. A bivariate analysis was followed by a multivariate logistic regression model to identify independent risk factors for acute postoperative infection.

A total of 356 patients were analyzed, with a mean age of 60.4years; 55.6% were male. The overall incidence of acute postoperative infection was 5.9% (21cases). Bivariate analysis revealed significant associations with infection for diabetes mellitus (P=.010), hypertension (P=.042), chronic corticosteroid use (P=.001), and surgical duration >3hours (P=.028). In the multivariate model, only diabetes mellitus remained a significant independent risk factor (OR: 3.36; 95%CI: 1.22-9.31; P=.019).

Diabetes mellitus was identified as the main independent risk factor for acute postoperative infection. This finding highlights the importance of a thorough preoperative assessment of surgical risk in diabetic patients and the need to provide them with adequate information during the informed consent process.