The pedicle screw instrumentation, useful for treating or correcting scoliosis, trauma, tumors, and spodylolsthesis, is particuarly valuable for the treatment of thoracic or thoracolumbar fractures. However, difficultes with instrumentation
requiring
extensive manuplation and the dead space created by the implants may invite infection, which may consequently cause skin and soft tissue necrosis. The tissue defect arising from such necrosis is usually difficult to repair.
Using Bilateral latissimus dorsi(LD) musculocutaneous advancement flap, we repaired 5×25cm sized spinal soft tissue defect resulting after the pedicle screw instrumentation in a 52-year-old man who had T12 fracture.
LD was separated from thoracolumbar fascia, the external oblique muscle, an the iliac crest. Posterior perforating vessels were isolated. Anterior margin of LD was released from its fascial attachments to skin and chest wall. Finally, the
musculocutaneous units were advanced to midline and closed primarily.
It appears that bilateral LD musculocutaneous advancement flap can widly be used in repairing large spinal defect following trauma or complication of surgery such as pedicle screw instumentation.
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