Abstract
Posterior trunk reconstruction is increasingly possible as a result of advances in spinal instrumentation, reconstructive approaches, and perioperative critical care. Extensive cases often require a muscle flap or complex closure to obliterate dead space. Postsurgical wound complications and subsequent reoperations can lead to neural injury, higher hospital costs, and longer hospitalizations. We aim to identify risk factors that are associated with increased length of stay (LOS) for patients receiving flaps to close a spinal defect. A single institution, retrospective cohort study was performed on all patients from 2002 to 2014 who received a muscle flap to close a spine defect. Medical and perioperative variables that were significantly associated with LOS (P < 0.05) in univariate analysis were included in a stepwise regression model. A total of 288 cases were identified. Presence of instrumentation, preoperative chemotherapy, wound dehiscence, cerebrospinal fluid leak, partial/total flap loss, and medical morbidity occurrence were all independently associated with increased LOS in a combined multivariate model (P < 0.02 for each of the 6 variables). Importantly, Kaplan-Meier analysis demonstrated that postoperative wound dehi...Continue Reading
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