Once the surgical fixation and decompression have been performed, the muscles are approximated over a deep suction drain using interrupted sutures.
For patients undergoing revision metastatic spine tumor surgery and/or with history of radiation, plastic surgery should perform the soft tissue reconstruction to decrease the risk of wound complications.
The fascial layer is closed with continuous or interrupted sutures.
For patients undergoing metastatic spine tumor surgery, intrawound vancomycin can be applied to decrease the risk of postoperative wound complications.
The approximation of the posterior cervicothoracic muscles is subject to considerable tension and fascial dehiscence. The use of nonabsorbable sutures for fascial closure should be considered.