Archives of Plastic Surgery

  • 제49권3호
  • /
  • Pages.365-368
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  • 2022
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
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Gluteus Maximus Muscle Flap in Tongue in Groove and Wrap Around Pattern for Refractory CSF Leakage in Extradural Cyst Patient

  • Park, Kyong Chan (Department of Plastic and Reconstructive Surgery and College of Medicine, Soonchunhyang University) ;
  • Lee, Jun Ho (Department of Plastic and Reconstructive Surgery and College of Medicine, Soonchunhyang University) ;
  • Shim, Jae Jun (Department of Neurosurgery, College of Medicine, Soonchunhyang University) ;
  • Lee, Hyun Ju (Department of Pathology, College of Medicine, Soonchunhyang University) ;
  • Choi, Hwan Jun (Department of Plastic and Reconstructive Surgery and College of Medicine, Soonchunhyang University)
  • 발행 : 2022.05.15
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초록

Spinal extradural arachnoid cyst (SEAC) is a rare disease and has surgical challenges because of the critical surrounding anatomy. We describe the rare case of a 58-year-old woman who underwent extradural cyst total excision with dural repair and presented with refractory cerebrospinal fluid (CSF) leakage even though two consecutive surgeries including dural defect re-repair and lumbar-peritoneal shunt were performed. The authors covered the sacral defect using bilateral gluteus maximus muscle flap in tongue in groove and wrap around pattern for protection of visible sacral nerve roots and blockage of CSF leakage point. With the flap coverage, the disappearance of cyst and fluid collection was confirmed in the postoperative radiological finding, and the clinical symptoms were significantly improved. By protecting the sacral nerve roots and covering the base of sacral defect, we can minimize the risk of complication and resolve the refractory fluid collection. Our results suggest that the gluteus muscle flap can be a safe and effective option for sacral defect and CSF leakage in extradural cyst or other conditions.

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과제정보

This work was supported by grants from National Research Foundation of Korea (NRF), grants founded by the Korea government (MSIT) (No. 2020R1A2C110089), and was supported by Soonchunhyang University research fund.

참고문헌

  1. Kelley SP, Ashford RU, Rao AS, Dickson RA. Primary bone tumours of the spine: a 42-year survey from the Leeds Regional Bone Tumour Registry. Eur Spine J 2007;16(03):405-409 https://doi.org/10.1007/s00586-006-0188-7
  2. Lee CH, Hyun SJ, Kim KJ, Jahng TA, Kim HJ. What is a reasonable surgical procedure for spinal extradural arachnoid cysts: is cyst removal mandatory? Eight consecutive cases and a review of the literature. Acta Neurochir (Wien) 2012;154(07):1219-1227 https://doi.org/10.1007/s00701-012-1356-7
  3. Woo JB, Son DW, Kang KT, et al. Spinal extradural arachnoid cyst. Korean J Neurotrauma 2016;12(02):185-190 https://doi.org/10.13004/kjnt.2016.12.2.185
  4. Basaldella L, Orvieto E, Dei Tos AP, Della Barbera M, Valente M, Longatti P. Causes of arachnoid cyst development and expansion. Neurosurg Focus 2007;22(02):E4
  5. Samartzis D, Gillis CC, Shih P, O'Toole JE, Fessler RG. Intramedullary spinal cord tumors: part I-epidemiology, pathophysiology, and diagnosis. Global Spine J 2015;5(05):425-435 https://doi.org/10.1055/s-0035-1549029
  6. Choi SW, Seong HY, Roh SW. Spinal extradural arachnoid cyst. J Korean Neurosurg Soc 2013;54(04):355-358 https://doi.org/10.3340/jkns.2013.54.4.355
  7. Oh JK, Lee DY, Kim TY, et al. Thoracolumbar extradural arachnoid cysts: a study of 14 consecutive cases. Acta Neurochir (Wien) 2012;154(02):341-348 https://doi.org/10.1007/s00701-011-1110-6
  8. Kim IS, Hong JT, Son BC, Lee SW. Noncommunicating spinal extradural meningeal cyst in thoracolumbar spine. J Korean Neurosurg Soc 2010;48(06):534-537 https://doi.org/10.3340/jkns.2010.48.6.534
  9. Choi JY, Kim SH, Lee WS, Sung KH. Spinal extradural arachnoid cyst. Acta Neurochir (Wien) 2006;148(05):579-585 https://doi.org/10.1007/s00701-006-0744-2
  10. Netra R, Min L, Shao Hui M, Wang JC, Bin Y, Ming Z. Spinal extradural meningeal cysts: an MRI evaluation of a case series and literature review. J Spinal Disord Tech 2011;24(02):132-136 https://doi.org/10.1097/BSD.0b013e3181e47b47
  11. Ishibe T, Senzoku F, Ikeda N, Kamba Y, Mikawa Y. Detection of the communicating hole(s) of spinal extradural arachnoid cysts using time-spatial labeling inversion pulse magnetic resonance imaging. Spine 2014;39(23):E1394-E1397 https://doi.org/10.1097/brs.0000000000000591
  12. Bae SW, Lim TK, Kim HS, Song BY. Hatchet-type gluteus maximus musculocutaneous flap for reconstruction of sacral pressure sore. Arch Hand Microsurg 2014;23(01):25-28
  13. Wanjala NF, Stanley KO. Island latissimus dorsi muscle flap and a perforator flap in repairing post-gunshot thoracic spine CSF fistula: case presentation. Case Rep Surg 2015;2015:219535 https://doi.org/10.1155/2015/219535
  14. Banerjee C, Cross B, Rumley J, Devine J, Ritter E, Vender J. Multiple-layer lumbosacral pseudomeningocele repair with bilateral para-spinous muscle flaps and literature review. World Neurosurg 2020;144:e693-e700 https://doi.org/10.1016/j.wneu.2020.09.038
  15. Singh S, Bhaisora KS, Sardhara J, et al. Symptomatic extradural spinal arachnoid cyst: more than a simple herniated sac. J Craniovertebr Junction Spine 2019;10(01):64-71 https://doi.org/10.4103/jcvjs.JCVJS_12_19