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Paraspinous muscle flaps

M E Manstein1, C H Manstein, G Manstein

  • 1Division of Plastic Surgery, Albert Einstein Medical Center, Philadelphia, PA, USA.

Annals of Plastic Surgery
|May 26, 1998
PubMed
Summary
This summary is machine-generated.

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The paraspinous muscle flap offers a simpler, effective solution for covering challenging midline posterior wounds, including those with exposed spinal hardware or cerebrospinal fluid leaks. This technique proved successful in most cases, simplifying complex reconstructions.

Area of Science:

  • Spinal reconstructive surgery
  • Microsurgery
  • Plastic surgery

Background:

  • Midline posterior wounds, particularly those with exposed spinal stabilization hardware, pose significant reconstructive challenges.
  • Traditional methods for thoracic spine wounds include latissimus dorsi flaps, while thoracolumbar wounds often require more complex flap options.
  • Existing techniques may be insufficient for certain challenging wound locations and complexities.

Observation:

  • The paraspinous muscle flap was utilized bilaterally to cover difficult midline posterior wounds in 12 patients.
  • Wound etiologies included exposed Harrington rods (8 patients), cerebrospinal fluid leaks (3 patients), and exposed spinous processes (1 patient).
  • In upper thoracic wounds (5 patients), paraspinous flaps were used adjunctively with latissimus flaps; in lower midline wounds (7 patients), paraspinous flaps were the sole coverage method.

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Findings:

  • The paraspinous muscle flap demonstrated effectiveness in covering a variety of complex midline posterior wounds.
  • A single failure occurred in a patient with a recurrent cerebrospinal fluid leak, attributed to inadequate postoperative cerebrospinal fluid pressure management.
  • The technique proved simpler and effective, particularly for lower midline wounds extending beyond the reach of traditional latissimus dorsi flaps.

Implications:

  • The paraspinous muscle flap represents a valuable, simpler alternative for reconstructive surgeons managing challenging midline posterior spinal wounds.
  • This flap technique expands reconstructive options, especially for thoracolumbar defects where traditional flaps may be less suitable.
  • Further investigation into optimizing postoperative care for cerebrospinal fluid leak repairs covered by these flaps may be warranted.