We report 2 patients with paraspinous sarcoma treated with omental transposition tunneled through a defect in the lumbar fascia that resurfaced in the soft tissues of the lower back. Traditional reconstruction with skin flaps was unsatisfactory because of prior irradiation to the area. In 1 patient the omentum obliterated a cavity connecting the dura to the skin to prevent cerebrospinal fluid leak. In the other patient a large soft tissue defect overlying the lower back and dura was covered with omentum and skin grafted. Although both patients lived < 2 years, the durable wound coverage remained intact over the surgical site.