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Use of Biologic Tissue Matrix in Post-Neurosurgical Posterior Trunk Reconstruction is Associated with Higher Wound Complication Rates
Devin Coon, M.D., M.S.E., Nicholas A. Calotta, BA, Justin M. Broyles, MD, Justin M. Sacks, MD.
Johns Hopkins University, Baltimore, MD, USA.

PURPOSE: Patients undergoing neurosurgical spine surgery for spinal tumors are increasingly undergoing soft tissue reconstruction involving biologic tissue matrices. There is limited data available on the safety of these devices in posterior trunk reconstruction.
METHODS: A cohort study of patients undergoing oncologic spine surgery with subsequent plastic surgery reconstruction was conducted. The primary outcome variable was development of a post-operative wound complication while secondary outcome variables were specific complications.
RESULTS: 293 cases in 260 patients were included. The matrix and non-matrix cohorts were similar in regards to demographic, medical, and surgical variables. Type of matrix and indications for use are presented in Table 1. The rate of all-cause wound complications in patients receiving biologic matrix for reconstruction was 49.2% whereas the all-cause complication rate for patients not receiving the matrix was 31.7% (p = 0.010). The rates of infection (34.9% versus 20.9%) and seroma (19.0% versus 10.0%) were also increased in patients receiving biologic matrix. In multivariate analysis, biologic matrix use remained a predictor of wound complications (p = 0.045), infection (p = 0.011) and seroma (p = 0.047).
CONCLUSIONS: We identified an increased risk of infection and seroma with the use of biologic tissue matrix in posterior trunk reconstruction even after controlling for reconstruction type and demographics. Careful consideration of the risks and benefits of using these devices in this population is warranted.
Table 1. Types of Matrix and Indications for Use
Type (N=63)Number (%)
AlloDerm48 (76%)
Surgimend11 (18%)
Other (Veritas/Strattice)4 (7%)
IndicationNumber (%)
Exposed or herniating rectum29 (46%)
Inadequate deep fascial support20 (32%)
Creation of pelvic floor sling7 (11%)
Spinal cord protection4 (6%)
Posterior pleural reconstruction3 (5%)


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