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Related Experiment Video

Updated: Feb 6, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Risk Scale to Guide Prophylactic Paraspinous Flap Closure in High-Risk Spine Surgery.

Allison Karwoski1, Esther Jung2, Kevin Schlidt2

  • 1Division of Plastic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, United States.

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|February 4, 2026
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Summary
This summary is machine-generated.

A new five-factor score helps identify patients at high risk for wound complications after posterior spine surgery. Selective use of prophylactic paraspinous flaps in these high-risk patients can significantly reduce reoperations.

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Area of Science:

  • Spine Surgery
  • Plastic Surgery
  • Wound Complications

Background:

  • Wound failure after posterior spine surgery can lead to serious complications.
  • Current criteria for using prophylactic paraspinous muscle flaps are inconsistent.

Purpose of the Study:

  • To develop a reliable method for identifying patients who would benefit from prophylactic paraspinous flaps.
  • To stratify risk for wound complications after posterior spine surgery.

Main Methods:

  • Retrospective cohort study of 281 complex posterior spine operations.
  • Development of a five-factor bedside score using pre- and intraoperative variables.
  • Comparison of prophylactic paraspinous flap closure versus standard primary closure.

Main Results:

  • A five-factor score identified low (7.9%), intermediate (11.7%), and high (23.2%) risk groups for wound complications.
  • In high-risk patients, prophylactic flaps reduced reoperations from 20% to 0% (ARR 20%, NNT 5).
  • American Society of Anesthesiologists (ASA) class ≥3 was associated with increased odds of wound complications.

Conclusions:

  • A simple five-factor score effectively stratifies baseline wound risk after posterior spine surgery.
  • Selective, preoperative use of prophylactic paraspinous flaps in high-risk patients may reduce returns to the operating room.