Objective:

To determine whether the preoperative VFA/SFA ratio at L4–L5 is associated with impaired wound healing after posterior lumbar fusion (PLF).

Approach:

Key Findings:

• Impaired wound healing occurred in 11.2% of patients.
• Patients with impaired healing had higher BMI and VFA/SFA ratios compared to those with good healing.
• Each 0.1 increase in VFA/SFA ratio was associated with an adjusted odds ratio of 1.32 for impaired wound healing.
• The AUC for VFA/SFA was 0.70, improving to 0.77 when added to a clinical model.

Interpretation:

Limitations:

• Retrospective design may introduce selection bias.
• Single institution study limits generalizability.
• Potential confounding factors not accounted for.

Conclusion:

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