Abstract
Patients requiring posterior fixation of the cervical spine are often elderly and frequently suffer from concurrent connective tissue disease together with steroid therapy. These patients are at increased risk of wound infection and breakdown. The extensive tissue dissection required, and the bulk of the posterior spinal devices may lead to difficult wound closure and delayed wound healing.
Over a four-year period, 1997 – 2001, 54 patients underwent posterior cervical spine fixation. Of these, eleven patients required muscle cover, four at the time of initial surgery and seven as a delayed procedure for wound breakdown. All these patients underwent trapezius muscle flap reconstruction (ten unilateral, one bilateral) which resulted in successful wound healing.
We make several recommendations for prevention of wound breakdown in this patient population. These include modification of the screw and rod fixation system to reduce the bulk, and assessment of the wound at the end of the primary procedure with a view to primary trapezius muscle flap transposition in those patients who are at risk of wound breakdown.
Abstracts prepared by Mr. A. J. Stirling, FRCS, and Miss A. Weaver. Correspondence should be addressed to Miss A. Weaver at the Research and Teaching Centre, Royal Orthopaedic Hospital, Northfield, Birmingham, B31 2AP, UK
BritSpine 2002, the second combined meeting of the British Association of Spinal Surgeons, the British Cervical Spine Society, The British Scoliosis Society and the Society for Back Pain Research, took place at the International Convention Centre in Birmingham UK between 27th February and 1st March 2002. The following presentations and posters were given and displayed.
