Spinoplastic Surgery at Stanford

Spino-plastics focuses on restoring soft-tissue coverage, stability, and wound healing in the back after spinal surgery, trauma, infection, or radiation. At Stanford Plastic & Reconstructive Surgery, our surgeons specialize in reconstructing complex spinal wounds, preventing hardware exposure, and creating durable coverage that supports healing and long-term function. Working closely with orthopedic spine surgeons, neurosurgeons, and infectious disease specialists, we provide coordinated care for both acute and chronic spinal reconstruction needs.

Stanford offers a range of techniques including muscle flaps, fasciocutaneous flaps, advancement flaps, and microsurgical free-tissue transfer when necessary. These procedures are designed to improve blood flow, close difficult wounds, treat infections, and protect underlying spinal hardware. Each reconstruction is tailored to wound size, location, and patient health status.

Muscle Flap Coverage

Muscle flaps—such as paraspinous, trapezius, latissimus dorsi, or gluteal flaps—provide durable coverage and vascularized tissue ideal for healing compromised areas. These flaps help manage infection, reinforce spinal stability, and prevent exposure of bone or hardware. Stanford surgeons select flap options based on the region of the spine and patient anatomy.

Fasciocutaneous & Local Flap Reconstruction

For smaller defects or wounds without hardware exposure, local fasciocutaneous flaps can be used to preserve muscle function while delivering reliable coverage. These flaps offer excellent contour and healing potential and are often used in patients requiring targeted soft-tissue replacement with minimal donor-site morbidity.

Microsurgical Free-Flap Reconstruction

In severe or recurrent spinal wounds—especially after radiation or multiple failed surgeries—microsurgical free-flap transfer may be required. This technique brings in healthy, well-vascularized tissue from another part of the body to restore coverage and support wound healing. Stanford’s microsurgeons use advanced imaging and supermicrosurgical techniques to ensure precise, durable results.

Common conditions and treatments include:

• Wounds or tissue breakdown after spine surgery

• Hardware exposure or at risk of exposure

• Chronic back wounds or non-healing surgical sites

• Spinal infection or osteomyelitis requiring soft-tissue coverage

• Wounds after radiation therapy

• Pressure sores over the spine or sacrum

• Muscle flap (paraspinous, trapezius, latissimus, gluteal) reconstruction

• Fasciocutaneous and perforator flap coverage

• Microsurgical free-flap reconstruction

• Wound debridement and advanced closure techniques

Stanford is a national leader in reconstructive spine surgery, offering unmatched expertise in complex spinal wound management and microsurgery. Our surgeons work hand-in-hand with orthopedic spine teams, neurosurgeons, and infectious disease specialists to ensure seamless, coordinated treatment. Patients benefit from innovative techniques, strong interdisciplinary partnerships, and comprehensive follow-up care designed for long-term healing and mobility.

Your consultation will include a detailed review of your surgical history, wound characteristics, imaging, and overall health. Your surgeon will discuss reconstructive options—including flap choices and timing—and coordinate with your spine surgeon when needed. After surgery, patients receive ongoing wound support, physical therapy guidance, and monitoring to ensure stable healing, infection control, and improved function.