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Paraspinous Muscle Flaps in Complex Pediatric Spine Surgeries: A 12-Year Single Institution Experience
Israel Falade1, Keon Min Park2, Nicole Conkling3
1From the School of Medicine.
Annals of Plastic Surgery
|April 2, 2024
Summary
Paraspinal muscle flaps can be safely used in pediatric spine surgery for complex cases. These flaps did not increase complications in high-risk children, suggesting their consideration for improved outcomes.
Area of Science:
- Pediatric Orthopedic Surgery
- Plastic and Reconstructive Surgery
- Wound Management
Background:
- Paraspinal flaps are established for adults but understudied in pediatric spine surgery.
- Limited data exists on the efficacy and safety of paraspinous muscle flap closure in pediatric patients.
Purpose of the Study:
- To compare clinical outcomes of pediatric spine surgery patients with and without paraspinous muscle flap closure.
- To evaluate the utility of paraspinous flaps in complex pediatric spinal cases.
Main Methods:
- Retrospective review of pediatric spine surgeries (2011-2022).
- Two cohorts: paraspinous flap closure vs. no flap closure.
- Patients matched by age, ASA classification, surgical history, and diagnosis.
Main Results:
- 14 patients received paraspinous flaps; 56 served as controls.
- Indications for flaps included complex disease (78.6%) and infection (21.4%).
- No significant difference in postoperative complications, despite higher-risk profiles in the flap group.
Conclusions:
- Paraspinal flaps were used in higher-risk pediatric patients (complex disease, underweight, preoperative infection).
- Flap coverage did not lead to increased postoperative complications.
- Paraspinal muscle flaps are a viable option for high-risk pediatric spine surgery patients.
