Division of Plastic Surgery, Department of Surgery, University of Nevada, Las Vegas School of Medicine, Las Vegas, Nevada, USA.
Division of Plastic and Reconstructive Surgery, Beaumont Health and Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA.
World Neurosurg. 2020 Dec;144:34-38. doi: 10.1016/j.wneu.2020.08.057. Epub 2020 Aug 11.
Long-term stabilization of the cervical spine after extensive multilevel tumor resection is difficult to achieve. The current standard approach of instrumentation combined with allograft or nonvascularized autograft is limited in settings of increased risk of nonunion or delayed union (i.e., prior radiation therapy or poorly vascularized wound beds).
We report the first time to our knowledge that a vascularized fibular free flap has been used to reconstruct the cervical column across 5 vertebral levels, from the craniocervical junction to the lower cervical spine. We describe a transoral approach to the area and compare this method with other reconstructive options.
Vascularized bone grafting is a viable alternative to achieve lasting stability because of hastened fusion time, limited reliance on osseous remodeling, and incorporation into the axial skeleton with strut strength.
广泛的多节段肿瘤切除后，颈椎的长期稳定难以实现。目前，器械固定联合同种异体骨或带血管自体骨的标准方法在存在非愈合或延迟愈合风险（如既往放疗或血供较差的创面）的情况下受到限制。
据我们所知，这是首次报道使用血管化腓骨游离皮瓣重建颈椎 5 个节段，从颅颈交界区到下颈椎。我们描述了经口入路的区域，并将这种方法与其他重建选择进行了比较。
血管化植骨是一种可行的替代方法，可以实现持久的稳定性，因为融合时间更快，对骨重塑的依赖性有限，并且与轴向骨骼融合，具有支撑强度。
