The AAPS 102nd Annual Meeting

The Utility of Prophylactic Muscle Flaps In Complex Pediatric Spine Surgery
Ashlie A. Elver, MD; Wesley Q. Zhang, BA; Laura S. Humphries, MD; Ian C. Hoppe, MD
The University of Mississippi Medical Center

Background
•Devasting complications (~8%)1 in pediatric spine surgery due to hardware, lack of soft tissue over bony vertebrae, proximity to central nervous system
•Local paraspinal flaps provide well vascularized, layered soft tissue closure & minimize dead space
•Often performed at salvage operations
•Adult studies indicate utility for prophylactic use of paraspinal flaps at index operations 2-5
•Only two single center studies in pediatric populations, both show promising results 6,7

Methods

•Retrospective analysis of Pediatric National Quality Improvement Program (PNSQIP)

•Patients from 2016 to 2021 undergoing complex spine surgery

•Cohorts: Paraspinal flaps vs no flaps, determined by additional CPT 15734 (muscle flap)

•Outcomes: Baseline characteristics, 30-day surgical site infections (SSI), wound healing complications

χ2, t-test, multivariate regression model, propensity score matching

Conclusion

•Patient selection favoring complex patients

•As such, flap patients had more complications, supporting the decision to perform prophylactic flaps

•No significant outcomes when baseline characteristics were controlled, supporting safe use

The AAPS 102nd Annual Meeting

The Utility Of Prophylactic Muscle Flaps In Complex Pediatric Spine Surgery

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