“…Currently, during the neurosurgical closure ofa bifid spine, if possible the paravertebral musculature and lateral spinal processes are rotated medially to create a new spinal canal [7], This protects the spinal cord, gives some subcutaneous padding and is believed to help counteract the development of a kyphosis [9], Undermining the skin laterally around the defect, however, is necessary to obtain closure, producing tension over the suture line. Covering the defect with the LLD flap introduces innervated muscle to counteract kyphosis, and also provides well-padded, well-vascularized skin coverage.…”