活动脊柱和骶骨的原发性肿瘤的手术通常需要复杂的重建技术来覆盖软组织缺陷并治疗伤口和脑脊液相关的并发症。大网膜的解剖、血管和免疫调节特性使其成为治疗放射性软组织损伤、感染和大面积伤口缺损的极佳局部基底。本研究描述了作者使用带蒂大网膜瓣重建复杂伤口的经验，以覆盖活动脊柱和骶骨原发性肿瘤手术中的缺陷。对 34 例原发性骶骨整块切除后接受带蒂大网膜瓣重建的患者进行回顾性队列分析2010 年至 2020 年间的移动脊柱肿瘤。该研究的重点是评估大网膜瓣使用的适应症，包括软组织覆盖、术后放射治疗的防护、感染管理、骨移植物的血管供应以及硬脑膜缺损和脑脊液渗漏修复。对患者人口特征、肿瘤特征、手术结果和随访数据进行分析，以确定手术的疗效和并发症发生率。从 2010 年到 2020 年，34 名患者在骶骨整块切除术后接受了带蒂大网膜瓣重建（34 名患者中的 24 名[71 %]）和活动脊柱（34 个中的 10 个 [29%]）原发性肿瘤，主要是脊索瘤。患者队列包括 21 名男性和 13 名女性，中位年龄（范围）为 60（32-89）岁。大网膜瓣最常见的适应症是软组织覆盖（34 例中的 20 例 [59%]）。其他适应症包括保护腹盆器官以进行术后放射治疗（34 例中的 6 例 [18%]）、治疗感染（34 例中的 5 例 [15%]）、为游离腓骨移植物提供血管供应（34 例中的 1 例 [3%]）、修复大的硬脑膜缺损和脑脊液渗漏（34 例中的 2 例 [6%]）。中位（范围）随访时间为 24（0-132）个月，在此期间，71%（34 名患者中的 24 名）患者不需要因伤口相关并发症而进行额外手术。在最后一次随访时，59%（34 人中的 20 人）疾病稳定，32%（34 人中的 11 人）复发、疾病进展或治疗后已出院至临终关怀医院。带蒂大网膜是一种有效的局部组织移植物可用于复杂的伤口重建和原发性脊柱肿瘤高风险闭合的管理。与其他方法相比，该技术的并发症发生率可能较低，并且可能会影响具有挑战性的病例的手术计划和皮瓣选择。

Surgery for primary tumors of the mobile spine and sacrum often requires complex reconstruction techniques to cover soft-tissue defects and to treat wound and CSF-related complications. The anatomical, vascular, and immunoregulatory characteristics of the omentum make it an excellent local substrate for the management of radiation soft-tissue injury, infection, and extensive wound defects. This study describes the authors' experience in complex wound reconstruction using pedicled omental flaps to cover defects in surgery for mobile spine and sacral primary tumors.A retrospective cohort analysis was conducted on 34 patients who underwent pedicled omental flap reconstruction after en bloc resection of primary sacral and mobile spine tumors between 2010 and 2020. The study focused on assessing the indications for omental flap usage, including soft-tissue coverage, protection against postoperative radiation therapy, infection management, vascular supply for bone grafts, and dural defect and CSF leak repair. Patient demographic characteristics, tumor characteristics, surgical outcomes, and follow-up data were analyzed to determine the procedure's efficacy and complication rates.From 2010 to 2020, 34 patients underwent pedicled omental flap reconstruction after en bloc resection of sacral (24 of 34 [71%]) and mobile spine (10 of 34 [29%]) primary tumors, mostly chordomas. The patient cohort included 21 men and 13 women with a median (range) age of 60 (32-89) years. The most common indication for omental flap was soft-tissue coverage (20 of 34 [59%]). Other indications included protecting abdominopelvic organs for postoperative radiation therapy (6 of 34 [18%]), treating infections (5 of 34 [15%]), providing vascular supply for free fibular bone graft (1 of 34 [3%]), and repairing large dural defects and CSF leak (2 of 34 [6%]). The median (range) follow-up was 24 (0-132) months, during which 71% (24 of 34) of patients did not require additional surgery for wound-related complications. At last follow-up, 59% (20 of 34) had stable disease and 32% (11 of 34) had recurrence, had progression of disease, or had been discharged to hospice after treatment.The pedicled omentum is an effective local tissue graft that can be used for complex wound reconstruction and management of high-risk closures in primary spine tumors. This technique may have a lower rate of complications than other approaches and may influence surgical planning and flap selection in challenging cases.