C5 Subcutaneous Fat Thickness Ratio Predicts Surgical Site Infection After Cervical Laminoplasty: A Propensity Score-Matched Study

Study DesignRetrospective case-control study.ObjectiveSurgical site infection(SSI) is a common complication following cervical spine surgery. Previous studies have used C5-level neck parameters to predict SSI risk. This study employed propensity score matching(PSM) to control for body mass index(BMI), aiming to compare the predictive validity of C5-level parameters against average neck parameters at C5, C6, and C7, while also exploring risk factors of SSI.MethodsPatients who underwent posterior single-door laminoplasty between November 2012 and April 2025 and developed postoperative SSI were selected as the case group(n = 42). Controls were patients who underwent the same procedure on the same day or within one day before or after those in the case group(n = 69). Data collected included baseline characteristics, surgical indicators, perioperative data, as well as C5, C6 and C7 neck parameters. PSM was conducted using a 1:1 nearest neighbor match with a caliper value set at 20%, matching variables including gender, age, height, weight, and BMI.ResultsAfter PSM, both groups comprised 38 patients each with no significant differences in baseline characteristics pre- or post-PSM. LASSO regression identified 2 variables: C5 subcutaneous fat thickness ratio and average subcutaneous fat thickness ratio. Multivariate logistic regression indicated that the C5 subcutaneous fat thickness ratio(P = 0.002, OR = 1.068, 95%CI:1.025-1.112) is an independent risk factor for SSI following cervical laminoplasty.ConclusionsThe C5 subcutaneous fat thickness ratio demonstrates a modest predictive advantage for SSI compared to average subcutaneous fat thickness ratio, supporting the feasibility of using preoperative MRI-based C5-level indicators to predict SSI after cervical spine surgery.