title: Paravertebral turnover flaps for closure of large spinal defects following tethered cord repair.
abstract: Reconstruction of large congenital spinal defects remains a challenge. We present our experience in closure of difficult spinal defects following repair of tethered cord, using paravertebral fascial or myofascial turnover flaps. Between 1996 and 2005, 23 patients were operated using paravertebral turnover flaps for closure of large spinal defects associated with tethered cord. Fifteen (65%) patients had lipomyelomeningoceles. Eleven (48%) patients had sacral defects, 10 (43%) had lumbosacral defects, and 2 (9%) had lumbar defects. Fourteen (61%) patients underwent closure using fascial turnover flaps. Myofascial turnover flaps were used in 9 (39%) patients. Following surgery, none of the patients developed cerebrospinal fluid (CSF) leaks, pseudomeningoceles, or subcutaneous infection. One patient suffered superficial necrosis and infection of the skin suture line, which healed secondarily. We conclude that fascial or myofascial paravertebral turnover flaps provide reliable coverage of difficult defects of the spinal CNS.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tel-Aviv Sourasky Medical Center and Dana Children's Hospital, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. udi.arad@gmail.com
authors.forename: Ehud
authors.initials: E
authors.lastname: Arad
authors.forename: Yoav
authors.initials: Y
authors.lastname: Barnea
authors.forename: Eyal
authors.initials: E
authors.lastname: Gur
authors.forename: Aharon
authors.initials: A
authors.lastname: Amir
authors.forename: David
authors.initials: D
authors.lastname: Leshem
authors.forename: Arik
authors.initials: A
authors.lastname: Zaretski
authors.forename: Shimon
authors.initials: S
authors.lastname: Rochkind
authors.forename: Liana
authors.initials: L
authors.lastname: Beny
authors.forename: Shlomi
authors.initials: S
authors.lastname: Constantini
authors.forename: Jerry
authors.initials: J
authors.lastname: Weiss
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D012189:Retrospective Studies; D016136:Spina Bifida Occulta / Q000601:surgery*; D013116:Spinal Cord / Q000601:surgery*; D013524:Surgical Flaps