Fusion of the lumbar spine with a free vascularized fibular bone graft: case report.

Spinal fusion with either non-vascularized or vascularized bone grafts has been well documented for inflammatory, degenerative, post-oncological and post-traumatic reconstruction Vascularized bone graft has been proven to have more rapid healing and better clinical results. A few reports have indicated that free vascularized fibular bone grafts have been used for reconstruction of the cervical and thoracic spine with good clinical results. We report a case of a third lumbar vertebra burst fracture successfully treated with a free vascularized fibula graft after failure of an initial conventional bone graft. The neurological symptoms improved significantly. The strong and straight bone quality makes the vascularized fibula an ideal choice for reconstruction of the spine. Vascularized fibula bone graft is an option in cases with failed nonvascularized bone grafts, in cases where an iliac bone is not suitable for reconstruction, or in cases where a poor recipient bed makes having well-vascularized bone necessary. This report describes our surgical approach and demonstrates the versatility of the free fibular osteoseptocutaneous flap for reconstruction of any portion of the spine.