Reconstruction of extensive posterior mid-thoracic soft-tissue defects after spinal surgery on irradiated skin

Abstract

A 56-year-old patient presented with neurological disorders resulting from an extrinsic medullary compression extending from T3 to T5 associated with a T4 corporeal invasion by a high-grade non-Hodgkin's malignant lymphoma. Treatment consisted in a laminectomy without spinal stabilization followed immediately by chemotherapy (VCAD) and locoregional radiotherapy (20 cycles of 50 Gy between T3 and T7 followed by nine sequences of 18 Gy). The evolution revealed unfavourable with reappearance of a compressive syndrome thus requiring surgical decompression combined with spinal stabilization. The immediate postoperative period was simple but a secondary wound dehiscence was observed surrounded by an inflammatory area of 15 cm on 12 cm. The authors describe the reconstruction by means of a trapezius musculocutaneous island flap. The results were satisfactory and corroborated those previously reported by various authors after use of this flap in similar situations.