{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:50:14Z","timestamp":1785891014400,"version":"3.56.0"},"reference-count":48,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,31]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Paraspinal muscle flaps have been used for complex wound reconstruction. Given the higher rates of wound complications associated with closure following posterior cervical decompression and fusion (PCDF), this study evaluated the use of paraspinal muscle flap advancement to mitigate this recognized risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective cohort of patients who underwent PCDF with conventional closure at an academic quaternary center between 2011 and 2022 was identified. Postoperative outcomes were compared with those of a prospectively maintained cohort of patients who underwent PCDF with paraspinal muscle flap advancement performed between 2023 and 2025. Exclusion criteria included active local or systemic infection and less than 3 months of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 380 patients underwent conventional closure, and 128 patients underwent closure with muscle flap advancement. Baseline characteristics were similar across cohorts, including BMI (p = 0.466) and the prevalence of diabetes mellitus (p = 0.597) and osteoporosis (p = 0.256). The muscle flap cohort was older (p = 0.004) and had higher rates of tobacco use (p = 0.002). There were no differences in preoperative prealbumin (p = 0.427) or albumin (p = 0.527). Operative indications (p = 0.568), revision surgeries (p &gt; 0.999), estimated blood loss (p = 0.465), and number of spinal levels fused (p = 0.067) were not significantly different between the cohorts. Rates of wound complications were comparable between the conventional and muscle flap cohorts, including infection (8% vs 3%, p = 0.132), wound dehiscence (12% vs 11%, p = 0.670), hematoma (1% vs 0%, p = 0.576), and seroma (5% vs 9%, p = 0.429). Wound-related reoperation occurred less frequently following muscle flap closure (12% vs 7%, p = 0.021). On multivariable logistic regression analysis, muscle flap closure was associated with reduced odds of infection (p = 0.005; OR 0.275, 95% CI 0.085\u20130.702) and wound-related reoperation (p = 0.026; OR 0.445, 95% CI 0.198\u20130.912).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Paraspinal muscle flap advancement following PCDF was associated with reduced odds of infection and wound-related reoperation after adjustment of preoperative and operative factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.2.spine251002","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:01:36Z","timestamp":1785283296000},"page":"1-8","source":"Crossref","is-referenced-by-count":0,"title":["Paraspinal muscle flap advancement to reduce wound complications following posterior cervical decompression and fusion"],"prefix":"10.3171","author":[{"given":"Samuel","family":"Adida","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh;"},{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel H.","family":"Wakelin","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regan M.","family":"Shanahan","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh;"},{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja D.","family":"Reddy","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Crall","sequence":"additional","affiliation":[{"name":"Infection Prevention and Control, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hansen","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D.","family":"Legarreta","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph S.","family":"Hudson","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Kojo","family":"Hamilton","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh;"},{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin","family":"Agarwal","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh;"},{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"Nat Rev Neurol","first-page":"108","article-title":"Degenerative cervical myelopathy - update and future directions","volume":"16","author":"Badhiwala JH","year":"2020","unstructured":"Badhiwala JH, Ahuja CS, Akbar MA,  Degenerative cervical myelopathy - update and future directions. Nat Rev Neurol. 2020;16(2):108\u2013124. doi:10.1038\/s41582-019-0303-0"},{"issue":"4","key":"b2","series-title":"Global Spine J","first-page":"597","article-title":"The prevalence of asymptomatic and symptomatic spinal cord compression on magnetic resonance imaging: a systematic review and meta-analysis","volume":"11","author":"Smith SS","year":"2021","unstructured":"Smith SS, Stewart ME, Davies BM, Kotter MRN. The prevalence of asymptomatic and symptomatic spinal cord compression on magnetic resonance imaging: a systematic review and meta-analysis. Global Spine J. 2021;11(4):597\u2013607. doi:10.1177\/2192568220934496"},{"key":"b3","series-title":"World Neurosurg","first-page":"e175","article-title":"Predicting trends in cervical spinal surgery in the United States from 2020 to 2040","volume":"141","author":"Neifert SN","year":"2020","unstructured":"Neifert SN, Martini ML, Yuk F,  Predicting trends in cervical spinal surgery in the United States from 2020 to 2040. World Neurosurg. 2020;141:e175\u2013e181. doi:10.1016\/j.wneu.2020.05.055"},{"issue":"6","key":"b4","series-title":"J Neurosurg Spine","first-page":"631","article-title":"Anterior cervical discectomy and fusion versus posterior decompression in patients with degenerative cervical myelopathy: a systematic review and meta-analysis","volume":"38","author":"Sattari SA","year":"2023","unstructured":"Sattari SA, Ghanavatian M, Feghali J,  Anterior cervical discectomy and fusion versus posterior decompression in patients with degenerative cervical myelopathy: a systematic review and meta-analysis. J Neurosurg Spine. 2023;38(6):631\u2013643. doi:10.3171\/2023.1.SPINE221244"},{"key":"b5","series-title":"J Clin Neurosci","first-page":"7","article-title":"Surgical decision-making in degenerative cervical myelopathy - anterior versus posterior approach","volume":"58","author":"Kato S","year":"2018","unstructured":"Kato S, Ganau M, Fehlings MG. Surgical decision-making in degenerative cervical myelopathy - anterior versus posterior approach. J Clin Neurosci. 2018;58:7\u201312. doi:10.1016\/j.jocn.2018.08.046"},{"issue":"10","key":"b6","series-title":"Spine J","first-page":"1714","article-title":"Outcomes of posterior cervical fusion and decompression: a systematic review and meta-analysis","volume":"19","author":"Youssef JA","year":"2019","unstructured":"Youssef JA, Heiner AD, Montgomery JR,  Outcomes of posterior cervical fusion and decompression: a systematic review and meta-analysis. Spine J. 2019;19(10):1714\u20131729. doi:10.1016\/j.spinee.2019.04.019"},{"key":"b7","series-title":"World Neurosurg","first-page":"e112","article-title":"Comparison of the inpatient complications and health care costs of anterior versus posterior cervical decompression and fusion in patients with multilevel degenerative cervical myelopathy: a retrospective propensity score-matched analysis","volume":"134","author":"Badhiwala JH","year":"2020","unstructured":"Badhiwala JH, Ellenbogen Y, Khan O,  Comparison of the inpatient complications and health care costs of anterior versus posterior cervical decompression and fusion in patients with multilevel degenerative cervical myelopathy: a retrospective propensity score-matched analysis. World Neurosurg. 2020;134:e112\u2013e119. doi:10.1016\/j.wneu.2019.09.132"},{"issue":"10","key":"b8","series-title":"JAMA","first-page":"942","article-title":"Effect of ventral vs dorsal spinal surgery on patient-reported physical functioning in patients with cervical spondylotic myelopathy: a randomized clinical trial","volume":"325","author":"Ghogawala Z","year":"2021","unstructured":"Ghogawala Z, Terrin N, Dunbar MR,  Effect of ventral vs dorsal spinal surgery on patient-reported physical functioning in patients with cervical spondylotic myelopathy: a randomized clinical trial. JAMA. 2021;325(10):942\u2013951. doi:10.1001\/jama.2021.1233"},{"issue":"1","key":"b9","series-title":"J Spine Surg","first-page":"323","article-title":"Complications following posterior cervical decompression and fusion: a review of incidence, risk factors, and prevention strategies","volume":"6","author":"Badiee RK","year":"2020","unstructured":"Badiee RK, Mayer R, Pennicooke B, Chou D, Mummaneni PV, Tan LA. Complications following posterior cervical decompression and fusion: a review of incidence, risk factors, and prevention strategies. J Spine Surg. 2020;6(1):323\u2013333. doi:10.21037\/jss.2019.11.01"},{"issue":"1","key":"b10","series-title":"Global Spine J","first-page":"3","article-title":"The incidence of infection after posterior cervical spine surgery: a 10 year review","volume":"2","author":"Barnes M","year":"2012","unstructured":"Barnes M, Liew S. The incidence of infection after posterior cervical spine surgery: a 10 year review. Global Spine J. 2012;2(1):3\u20136. doi:10.1055\/s-0032-1307252"},{"issue":"7","key":"b11","series-title":"Global Spine J","first-page":"640","article-title":"Perioperative complications of cervical spine surgery: analysis of a prospectively gathered database through the Association for Collaborative Spinal Research","volume":"6","author":"Leckie S","year":"2016","unstructured":"Leckie S, Yoon ST, Isaacs R,  Perioperative complications of cervical spine surgery: analysis of a prospectively gathered database through the Association for Collaborative Spinal Research. 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Spine J. 2009;9(1):31\u201338. doi:10.1016\/j.spinee.2008.07.005"},{"issue":"4","key":"b13","series-title":"Spine J","first-page":"504","article-title":"Risk factors for surgical site infection after posterior cervical spine surgery: an analysis of 5,441 patients from the ACS NSQIP 2005-2012","volume":"16","author":"Sebastian A","year":"2016","unstructured":"Sebastian A, Huddleston P III, Kakar S, Habermann E, Wagie A, Nassr A. Risk factors for surgical site infection after posterior cervical spine surgery: an analysis of 5,441 patients from the ACS NSQIP 2005-2012. Spine J. 2016;16(4):504\u2013509. doi:10.1016\/j.spinee.2015.12.009"},{"issue":"2","key":"b14","series-title":"EFORT Open Rev","first-page":"109","article-title":"Intraoperative vancomycin powder to reduce surgical site infections after posterior spine surgery: a systematic review and meta-analysis","volume":"7","author":"Luo H","year":"2022","unstructured":"Luo H, Ren Y, Su Y, Xue F, Hong Z. 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