Abstract：
Paraspinal muscle (PSM) flaps can be mobilized with superficial undermining and lateral release from the thoracolumbar fascia and/or deep undermining and medial release from the transverse processes and ribs. The objective of the study was to compare the effect of the PSM flap technique on drain use, retention, and complication rates.
A retrospective chart review was performed for patients who underwent spinal coverage with PSM flaps at a single institution from April 2020 to June 2021. Patient demographics, preoperative comorbidities, surgical technique, drain usage, and postoperative complications were analyzed to compare the effects of different PSM flap surgical techniques on postoperative drain use and complications.
Sixty patients were included. Both superficial and deep releases were performed in half (47%) of the cases, while the remainder was split between superficial (25%) and deep (28%) releases. Drains were used less frequently for the deep release (35%) than the superficial (93%) or both releases (96%, p < 0.01). The deep release had shorter mean drain retention time (5.8 days) than the superficial (30.3 days) or both releases (24.8 days, p < 0.01). There were no significant differences between the techniques in terms of complications. For the deep release, the use of drains was not associated with a reduction in complications (odds ratio 0.91 [0.84 - 0.98], p = 0.97).
In a selected patient population, a \"deep release only\" PSM flap technique may allow for drainless spinal closure without an increased risk of seroma or other complications.
A retrospective chart review was performed for patients who underwent spinal coverage with PSM flaps at a single institution from April 2020 to June 2021. Patient demographics, preoperative comorbidities, surgical technique, drain usage, and postoperative complications were analyzed to compare the effects of different PSM flap surgical techniques on postoperative drain use and complications.
Sixty patients were included. Both superficial and deep releases were performed in half (47%) of the cases, while the remainder was split between superficial (25%) and deep (28%) releases. Drains were used less frequently for the deep release (35%) than the superficial (93%) or both releases (96%, p < 0.01). The deep release had shorter mean drain retention time (5.8 days) than the superficial (30.3 days) or both releases (24.8 days, p < 0.01). There were no significant differences between the techniques in terms of complications. For the deep release, the use of drains was not associated with a reduction in complications (odds ratio 0.91 [0.84 - 0.98], p = 0.97).
In a selected patient population, a \"deep release only\" PSM flap technique may allow for drainless spinal closure without an increased risk of seroma or other complications.
摘要：
背景：椎旁肌（PSM）皮瓣可以通过表面破坏和从胸腰椎筋膜的外侧释放和/或深度破坏和从横突和肋骨的内侧释放来动员。这项研究的目的是比较PSM皮瓣技术对排水管使用的影响，保留,和并发症发生率。
方法：对2020年4月至2021年6月在单一机构接受PSM皮瓣覆盖脊柱的患者进行回顾性图表回顾。患者人口统计学，术前合并症,外科技术,排水管使用情况,并对术后并发症进行分析,比较不同PSM皮瓣手术技术对术后引流管使用及并发症的影响。
结果：纳入60例患者。在一半（47％）的病例中进行了浅层和深层释放，而其余的则分为浅层(25%)和深层(28%)释放。深度释放（35％）的使用频率低于表面释放（93％）或同时释放（96％，p<0.01)。深度释放的平均引流保留时间（5.8天）比浅层释放（30.3天）短，或同时释放（24.8天，p<0.01)。在并发症方面，技术之间没有显着差异。对于深度释放，引流管的使用与并发症的减少无关（比值比0.91[0.84-0.98]，p=0.97）。
结论：在选定的患者群体中，“仅深度释放”PSM皮瓣技术可以实现无引流的脊柱闭合，而不会增加血清肿或其他并发症的风险。
方法：对2020年4月至2021年6月在单一机构接受PSM皮瓣覆盖脊柱的患者进行回顾性图表回顾。患者人口统计学，术前合并症,外科技术,排水管使用情况,并对术后并发症进行分析,比较不同PSM皮瓣手术技术对术后引流管使用及并发症的影响。
结果：纳入60例患者。在一半（47％）的病例中进行了浅层和深层释放，而其余的则分为浅层(25%)和深层(28%)释放。深度释放（35％）的使用频率低于表面释放（93％）或同时释放（96％，p<0.01)。深度释放的平均引流保留时间（5.8天）比浅层释放（30.3天）短，或同时释放（24.8天，p<0.01)。在并发症方面，技术之间没有显着差异。对于深度释放，引流管的使用与并发症的减少无关（比值比0.91[0.84-0.98]，p=0.97）。
结论：在选定的患者群体中，“仅深度释放”PSM皮瓣技术可以实现无引流的脊柱闭合，而不会增加血清肿或其他并发症的风险。
