Riasa I Nyoman P, Kawilarang Bertha
From the Plastic Reconstructive and Aesthetic Surgery IGNG Prof Ngoerah Hospital, Udayana University, Denpasar, Bali, Indonesia.
Plast Reconstr Surg Glob Open. 2023 Jun 15;11(6):e5079. doi: 10.1097/GOX.0000000000005079. eCollection 2023 Jun.
Reconstructive surgeons frequently face large structural abnormalities after spine resection. Unlike defects in the mandible or long bone, where a free vascularized fibular graft (FVFG) is a popular alternative for segmental osseous reconstruction, data on the use of an FVFG in the spine are still limited. The purpose of this study was to comprehensively describe and analyze the outcome of spinal reconstruction utilizing FVFG.
The extensive search included the following databases: PubMed, ScienceDirect, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and Cochrane for relevant studies published up to January 20, 2023, according to PRISMA 2020 guidelines. Demographic data, flap success, recipient vessels, and flap-related complications were evaluated.
We identified 25 eligible studies involving 150 patients, consisting of 82 men and 68 women. Spinal reconstruction utilizing FVFG is mostly reported in the case of spinal neoplasm, followed by spinal infection (osteomyelitis and spinal tuberculosis) and spinal deformities. The cervical spine is the most common vertebral defect reported in the studies. All studies summarized in the present study reported successful spinal reconstruction, while wound infection was the most reported postoperative complication after spinal reconstruction utilizing FVFG.
The results of the current study highlight the ability and superiority of using FVFG in spinal reconstruction. Despite being technically challenging, this strategy provides enormous benefits to patients. However, a further additional large-scale study is required to corroborate these findings.
重建外科医生在脊柱切除术后经常面临较大的结构异常。与下颌骨或长骨缺损不同，游离血管化腓骨移植（FVFG）是节段性骨重建的常用替代方法，但关于FVFG在脊柱中应用的数据仍然有限。本研究的目的是全面描述和分析利用FVFG进行脊柱重建的结果。
根据PRISMA 2020指南，广泛检索了以下数据库：PubMed、ScienceDirect、Web of Science、护理学与健康相关文献累积索引以及Cochrane，以查找截至2023年1月20日发表的相关研究。评估了人口统计学数据、皮瓣成功率、受区血管和皮瓣相关并发症。
我们确定了25项符合条件的研究，涉及150名患者，其中男性82名，女性68名。利用FVFG进行脊柱重建多见于脊柱肿瘤病例，其次是脊柱感染（骨髓炎和脊柱结核）和脊柱畸形。颈椎是研究中报告的最常见椎体缺损部位。本研究总结的所有研究均报告脊柱重建成功，而伤口感染是利用FVFG进行脊柱重建后报告最多的术后并发症。
本研究结果突出了使用FVFG进行脊柱重建的能力和优势。尽管在技术上具有挑战性，但该策略为患者带来了巨大益处。然而，需要进一步开展大规模研究来证实这些发现。
