Development and validation of a nomogram prediction model for surgical site infection after instrumentation for degenerative lumbar spinal diseases
Authors' conclusion
This study found a moderate 3.5% SSI rate following instrumentation for degenerative lumbar spinal diseases and identified several risk factors.
Study context
- Population
- Patients undergoing posterior instrumentation for degenerative lumbar spinal diseases, January 2020–December 2022, minimum 12-month follow-up687 men · 775 women
- Participants
- 1,462 patients
- Exposure
- Surgical site infection (SSI) vs no SSI
- Outcome
- Incidence and risk factors for SSI
Methodological detailsprediction model development and validation, multivariate logistic regression, nomogram, bootstrap validation
- Prediction model development and validation
- Multivariate logistic regression
- Nomogram
- Bootstrap validation
Main finding
As reported in the abstract
SSI incidence and independent risk factors
- SSI incidence (53 patients)
- 3.5%
- ASA class III or IV vs I or II, OR
- 2.362 (95% CI 1.312 to 4.249)
- Surgery involving sacral vertebrae, OR
- 2.319 (95% CI 1.242 to 4.330)
- Open vs minimally invasive surgery, OR
- 3.081 (95% CI 1.701 to 5.581)
- Prolonged surgical time, per hour increase, OR
- 1.482 (95% CI 1.017 to 2.160)
- Preoperative hemoglobin < 100 g/L, OR
- 4.962 (95% CI 1.728 to 6.943)
Observational data: associations, not effects.
Further findings
Nomogram discrimination (C-index)
- C-index
- 0.743 (95% CI 0.682-0.804)
- C-index after 1,000 bootstrap verifications
- 0.722
- Calibration curve: predicted SSI probability aligned well with actual probability
Original publication
Development and validation of a nomogram prediction model for surgical site infection after instrumentation for degenerative lumbar spinal diseases. Perioper Med (Lond). Published 7 July 2025. doi:10.
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