Chronic osteomyelitis of the spine managed with a free flap of latissimus dorsi: A case report

Study Design. A patient with intractable spinal osteomyelitis who underwent surgery 12 times with persistent exposed bone is presented. Objectives. To demonstrate the effectiveness of free-flap grafting for managing difficult spinal osteomyelitis wounds. Summery of Background Data. Conventional procedures can usually achieve wound closure, but they may not work for advanced cases. Methods. A free latissimus dorsi flap was transferred for reconstruction. The muscle component was used to obliterate the dead space and cover the exposed bone, and the skin component was used for tension-free closure of the wound. Results. The wound healed dramatically. There was no recurrence of infection at 2-year follow-up evaluation. Conclusions. For an intractable spinal osteomyelitis wound, a free flap should be considered, although the surgery is difficult. Technical precautions in performing this operation are given.