Adipofascial Flap Coverage of Lumbosacral Soft Tissue Defect With Persistent CSF Leak in Revision Spine Surgery: A
Stephen J Lewis1, Fan Jiang1, Ian H Y Wong1,2
1Division of Orthopaedic Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
JBJS Case Connector
|July 30, 2026
Abstract
Case:
This case describes the novel use of a local adipofascial flap for the surgical management of a cerebrospinal fluid (CSF) draining lumbosacral wound, after revision decompression and fusion for a high-grade spondylolisthesis in a 20-year-old woman.
Conclusion:
The local medially based flap can be considered for coverage of uncontrollable CSF leaks at the lumbosacral junction where limited options are available. In this case, the flap successfully filled the dead space and provided the necessary dural coverage for successful healing of the wound.