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Case report| Volume 65, ISSUE 12, e344-e347, December 2012

Multilevel cervical reconstruction with no remaining hardware: The potential of a vascularised fibular strut graft

Published:October 08, 2012DOI:https://doi.org/10.1016/j.bjps.2012.09.007

      Summary

      We present a case of a cervical chordoma extending from C3 to C6, treated by surgical resection followed by reconstruction in two stages with a vascularised fibular strut graft anteriorly and fibular allografts posteriorly. The goal was to achieve a stable reconstruction without any metal hardware to allow for increased accuracy of the adjuvant radiotherapy. The advantages of a vascularised fibula flap to realise this are discussed.

      Keywords

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      References

        • Jiang L.
        • Liu Z.J.
        • Liu X.G.
        • et al.
        Upper cervical spine chordoma of C2–C3.
        Eur Spine J. 2009; 18: 293-300
        • Wright N.M.
        • Kaufman B.A.
        • Haughey B.H.
        • Lauryssen C.
        Complex cervical spine neoplastic disease: reconstruction after surgery by using a vascularized fibular strut graft. Case report.
        J Neurosurg. 1999; 90: 133-137
        • Macdonald R.L.
        • Fehlings M.G.
        • Tator C.H.
        • et al.
        Multilevel anterior cervical corpectomy and fibular fusion for cervical myelopathy.
        J Neurosurg. 1997; 86: 990-997
        • Singh K.
        • Vaccaro A.R.
        • Kim J.
        • Lorenz E.P.
        • Lim T.H.
        • An H.S.
        Biomechanical comparison of cervical spine reconstructive techniques after a multilevel corpectomy of the cervical spine.
        Spine. 2003; 28: 2352-2358
        • Acosta F.L.
        • Aryan H.E.
        • Ames C.P.
        Successful outcome of six-level cervicothoracic corpectomy and circumferential reconstruction: case report and review of literature on multilevel cervicothoracic corpectomy.
        Eur Spine J. 2006; 15: S670-S674
        • Fernyhough J.C.
        • White J.I.
        • LaRocca H.
        Fusion rates in multilevel cervical sponylosis comparing allograft fibula with autograft fibula in 126 patients.
        Spine. 1991; 16: S561-S564
        • Krishnan K.G.
        • Müller A.
        Ventral cervical fusion at multiple levels using free vascularized double-islanded fibula – a technical report and review of the relevant literature.
        Eur Spine J. 2002; 11: 176-182
        • Freidberg S.R.
        • Gumley G.J.
        • Pfeifer B.A.
        • Hybels R.L.
        Vascularized fibular graft to replace resected cervical vertebral bodies. Case report.
        J Neurosurg. 1989; 71: 283-286
        • Hussain M.
        • Nassr A.
        • Natarajan R.N.
        • An H.S.
        • Andersson G.B.
        Biomechanical effects of anterior, posterior, and combined anterior–posterior instrumentation techniques on the stability of a multilevel cervical corpectomy construct: a finite element model analysis.
        Spine J. 2011; 11: 324-330
        • Lee M.J.
        • Ondra S.L.
        • Mindea S.A.
        • Fine N.A.
        • Dumanian G.A.
        Indications and rationale for use of vascularized fibula bone flaps in cervical spine arthrodeses.
        Plast Reconstr Surg. 2005; 116: 1-7
        • Winters H.A.
        • van Engeland A.E.
        • Jiya T.U.
        • van Royen B.J.
        The use of free vascularized bone grafts in spinal reconstruction.
        J Plast Reconstr Aesthet Surg. 2010; 63: 516-523