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旋转皮瓣关闭巨大的腰骶部脊髓脊膜膨出:技术说明。

Rotation flap closure of a giant dorsolumbar myelomeningocele: technical note.

机构信息

Department of Neurosurgery, Hospital Universitario Torrecárdenas, Almería, Spain.

出版信息

Childs Nerv Syst. 2021 Apr;37(4):1323-1326. doi: 10.1007/s00381-020-05021-7. Epub 2021 Jan 16.

Abstract

PURPOSE

Myelomeningocele (MMC) is the most prevalent form of spina bifida aperta. Here we present the surgical repair technique of a dorsolumbar myelomeningocele with a large associated soft tissue defect.

METHODS

Data concerning the anamnesis and complementary studies were obtained from the clinical history. Surgical images were obtained in the operation room during surgery.

RESULT

We describe the case of a newborn with a dorsal myelomeningocele with a placode in the central area and a large associated skin defect of 12 x× 12 cm. Urgent intervention was carried out on the day of birth with placode reconstruction. Dorsal and gluteus maximus muscle rotation and skin rotation flap were performed in order to achieve complete closure of the myocutaneous defect. The patient presented a good recovery with no new neurological deficit.

CONCLUSION

Myelomeningocele may be associated with large myocutaneous defects that can be difficult to correct by primary closure. In these cases, rotation flaps may be necessary to achieve complete closure.

摘要

目的

脊膜脊髓膨出(MMC)是开放性脊柱裂最常见的形式。本文介绍了一种腰骶部脊膜脊髓膨出伴大的相关软组织缺损的手术修复技术。

方法

从临床病史中获取有关病史和补充研究的数据。在手术室的手术过程中获得手术图像。

结果

我们描述了一例新生儿背部脊膜脊髓膨出,中央区域有一个斑块,伴有 12×12cm 的大相关皮肤缺损。出生当天即进行了紧急干预,进行了斑块重建。进行了背侧和臀大肌旋转以及皮肤旋转皮瓣,以实现肌皮缺损的完全闭合。患者恢复良好,无新的神经功能缺损。

结论

脊膜脊髓膨出可伴大的肌皮缺损,难以通过一期闭合来纠正。在这些情况下,可能需要旋转皮瓣来实现完全闭合。

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