Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Reverse Latissimus Dorsi Muscle Flap for an Extensive Soft Tissue Defect Accompanied by Infectious Spondylitis

  • Yoo, Chai Min (Department of Neurosurgery, Gyeongsang National University School of Medicine) ;
  • Kang, Dong Ho (Department of Neurosurgery, Gyeongsang National University School of Medicine) ;
  • Hwang, Soo Hyun (Department of Neurosurgery, Gyeongsang National University School of Medicine) ;
  • Park, Kyung Bum (Department of Neurosurgery, Gyeongsang National University School of Medicine)
  • Received : 2012.04.25
  • Accepted : 2012.10.04
  • Published : 2012.10.28
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Abstract

Spinal infection is an inflammatory process around the vertebral body, and it can extend to the epidural space, posterior elements and paravertebral soft tissues. Infectious spondylitis is a rare infectious disorder, which is often associated with significant neurologic deficits and mortality. When an extensive soft tissue defect is accompanied by infectious spondylitis, effective infection control and proper coverage of soft tissue are directly connected to successful outcomes. However, it is not simple to choose the appropriate treatment methods for infectious spondylitis accompanied by a soft tissue defect. Herein, we report a case of severe infectious spondylitis that was accompanied by an extensive soft tissue defect which was closed with a reverse latissimus muscle flap after traumatic spinal epidural hemorrhage.

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References

  1. Casas LA, Lewis VL Jr : A reliable approach to the closure of large acquired midline defects of the back. Plast Reconstr Surg 84 : 632-641, 1989
  2. Chen HC, Chen HH, Chen WJ, Tang YB : Chronic osteomyelitis of the spine managed with a free flap of latissimus dorsi. A case report. Spine (Phila Pa 1976) 21 : 2016-2018, 1996 https://doi.org/10.1097/00007632-199609010-00018
  3. Frank CJ, Brantigan J, Cronan J : Bilateral interconnected latissimus dorsi-gluteus maximus muscular cutaneous flaps for closure of subfascial infections in lumbar spinal surgery. A technical note. Spine (Phila Pa 1976) 22 : 564-567, 1997 https://doi.org/10.1097/00007632-199703010-00021
  4. Garvey PB, Rhines LD, Dong W, Chang DW : Immediate soft-tissue reconstruction for complex defects of the spine following surgery for spinal neoplasms. Plast Reconstr Surg 125 : 1460-1466, 2010 https://doi.org/10.1097/PRS.0b013e3181d5125e
  5. Hanaoka N, Kawasaki Y, Sakai T, Nakamura T, Nanamori K, Nakamura E, et al. : Percutaneous drainage and continuous irrigation in patients with severe pyogenic spondylitis, abscess formation, and marked bone destruction. J Neurosurg Spine 4 : 374-379, 2006 https://doi.org/10.3171/spi.2006.4.5.374
  6. Hung SJ, Chen HC, Wei FC : Free flaps for reconstruction of the lower back and sacral area. Microsurgery 20 : 72-76, 2000 https://doi.org/10.1002/(SICI)1098-2752(2000)20:2<72::AID-MICR5>3.0.CO;2-1
  7. Khanna RK, Malik GM, Rock JP, Rosenblum ML : Spinal epidural abscess : evaluation of factors influencing outcome. Neurosurgery 39 : 958-964, 1996
  8. Klink BK, Thurman RT, Wittpenn GP, Lauerman WC, Cain JE : Muscle flap closure for salvage of complex back wounds. Spine (Phila Pa 1976) 19 : 1467-1470, 1994 https://doi.org/10.1097/00007632-199407000-00008
  9. Kroll SS, Rosenfield L : Perforator-based flaps for low posterior midline defects. Plast Reconstr Surg 81 : 561-566, 1988 https://doi.org/10.1097/00006534-198804000-00012
  10. Manstein ME, Manstein CH, Manstein G : Paraspinous muscle flaps. Ann Plast Surg 40 : 458-462, 1998 https://doi.org/10.1097/00000637-199805000-00002
  11. Meiners T, Flieger R, Jungclaus M : Use of the reverse latissimus muscle flap for closure of complex back wounds in patients with spinal cord injury. Spine (Phila Pa 1976) 28 : 1893-1898, 2003 https://doi.org/10.1097/01.BRS.0000083173.86878.1B
  12. Nagata K, Ohashi T, Ariyoshi M, Sonoda K, Imoto H, Inoue A : Percutaneous suction aspiration and drainage for pyogenic spondylitis. Spine (Phila Pa 1976) 23 : 1600-1606, 1998 https://doi.org/10.1097/00007632-199807150-00018
  13. Paonessa KJ, Hostnik WJ, Zide BM : Use of tissue expanders for wound closure of spinal infections or dehiscence. Orthop Clin North Am 27 : 155-170, 1996
  14. Stevenson TR, Rohrich RJ, Pollock RA, Dingman RO, Bostwick J 3rd : More experience with the "reverse" latissimus dorsi musculocutaneous flap : precise location of blood supply. Plast Reconstr Surg 74 : 237-243, 1984 https://doi.org/10.1097/00006534-198408000-00011
  15. Wendt JR, Gardner VO, White JI : Treatment of complex postoperative lumbosacral wounds in nonparalyzed patients. Plast Reconstr Surg 101 : 1248-1253; discussion 1254, 1998