Abstract:
:The closure of myelorachischisis defects has been difficult and at times complicated. Over the past 2 decades, the use of rotational advancement flaps has been increasingly popular, but can be attended by instances of skin ischemia and necrosis. The development of the myocutaneous and muscle flap concept has aided reconstructive surgery. Extensive experience with the useful latissimus dorsi flap with and without overlying skin has been obtained for the reconstruction of a variety of truncal defects. We describe the use of bilateral "reverse" latissimus dorsi muscle flaps based on the paraspinal perforators for the closure of myelorachischisis defects in two patients. Coverage was uneventful in both instances. A 2-year follow-up revealed no compromise of upper extremity function due to sacrifice of the latissimus dorsi muscles. We offer an approach to the problem of closure of large myelorachischisis defects: bilateral reverse latissimus dorsi muscle flaps and delayed skin coverage. This approach seems to offer a good muscle layer over the dural closure and to provide long-standing durable coverage without apparent compromise of upper extremity function.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Clark DH,Walsh JW,Luce EAdoi
10.1227/00006123-198209000-00015subject
Has Abstractpub_date
1982-09-01 00:00:00pages
423-5issue
3eissn
0148-396Xissn
1524-4040journal_volume
11pub_type
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