Soft Tissue Reconstruction of Large Spinal Defects: A 12-year Institutional Experience.

Background: Radical spinal resections can lead to considerable defects requiring soft tissue reconstruction. The purpose of this study was to review our institutional experience of over a decade with reconstruction of spinal defects and identify risk factors predictive of wound complications, particularly focusing on timing of reconstruction with ablative surgery. Methods: We retrospectively reviewed patients who underwent spinal resection and required soft tissue reconstruction from 2002-2014. Patient characteristics, operative details, and complication rates were collected. Logistic regression was performed to identify risk factors for wound complications. Results: Of 289 reconstructions performed in 259 patients, 64 cases (22.1%) had major wound complications requiring reoperation. Lumbosacral defects were the most common location (43.6%) and paraspinous muscle flaps were the preferred reconstructive method used for all defect regions. A total of 224 reconstructions (77.5%) were performed immediately at time of spinal surgery, and 65 (22.5%) were performed in delayed fashion as result of wound complications from previous spinal surgery. Patients with immediate reconstructions required significantly fewer instrumentation removal rates (0.9% v. 4.6%, p=0.043), unplanned reoperations (0.5 v. 1.3, p

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