The Dorsal Scapular Artery Perforator Flap: A Complete Muscle-sparing Technique
Bibliographic record
Abstract
Cervical and thoracic spine reconstruction can be a difficult area to provide stable soft tissue coverage. Historically, trapezius myocutaneous flaps and trapezius muscle turnover flaps have proven to be reliable and versatile methods for the reconstruction of these areas. However, sequelae such as restriction of shoulder movement have been reported, as well as unsightly "humpback" contour deformities from turnover flap bulk. The use of the trapezius muscle for coverage has evolved to include descriptions of a trapezius perforator flap to address some of the issues of donor site morbidity, as it is described as a muscle-sparing technique. Although described as "muscle-sparing," these approaches nonetheless involve sacrifice of trapezius muscle overlying the pedicle as that musculature is "deroofed" and divided off the pedicle during dissection. In this article, we present a detailed technical description of our novel technique to the trapezius perforator flap using a dorsal scapular artery flap for spinal reconstruction that is truly, completely muscle-sparing. This technique may prove useful for those patients in which even minimal disruption of trapezius muscle fibers is undesirable.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".