Occipital Vascularized Bone Graft for Reconstruction of a C3-C7 Defect

I. Nyoman P. Riasa, MD; Edward M. Reece, MD, MS, MBA; Tjokorda G. B. Mahadewa, MD, PhD; Bertha Kawilarang, MD; Jonathan L. Jeger, MB, BCh, BAO; Steven Awyono, MD; Made Bhuwana Putra, MD; Kevin Kristian Putra, MD; I. Putu Ramanda Suadnyana, MD

doi:10.1097/GOX.0000000000006268

Plastic and Reconstructive Surgery, Global Open (Nov 2024)

Occipital Vascularized Bone Graft for Reconstruction of a C3-C7 Defect

I. Nyoman P. Riasa, MD,
Edward M. Reece, MD, MS, MBA,
Tjokorda G. B. Mahadewa, MD, PhD,
Bertha Kawilarang, MD,
Jonathan L. Jeger, MB, BCh, BAO,
Steven Awyono, MD,
Made Bhuwana Putra, MD,
Kevin Kristian Putra, MD,
I. Putu Ramanda Suadnyana, MD

Affiliations

I. Nyoman P. Riasa, MD: From the * Plastic Reconstructive and Aesthetic Surgery Division, Faculty of Medicine, Udayana University, Prof. Dr. I.G..G. Ngoerah General Hospital, Denpasar, Bali, Indonesia
Edward M. Reece, MD, MS, MBA: † Division of Plastic and Reconstructive Surgery, Mayo Clinic, Phoenix, Ariz.
Tjokorda G. B. Mahadewa, MD, PhD: ‡ Neurosurgery Division, Department of Surgery, Faculty of Medicine, Udayana University, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia.
Bertha Kawilarang, MD: From the * Plastic Reconstructive and Aesthetic Surgery Division, Faculty of Medicine, Udayana University, Prof. Dr. I.G..G. Ngoerah General Hospital, Denpasar, Bali, Indonesia
Jonathan L. Jeger, MB, BCh, BAO: † Division of Plastic and Reconstructive Surgery, Mayo Clinic, Phoenix, Ariz.
Steven Awyono, MD: ‡ Neurosurgery Division, Department of Surgery, Faculty of Medicine, Udayana University, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia.
Made Bhuwana Putra, MD: ‡ Neurosurgery Division, Department of Surgery, Faculty of Medicine, Udayana University, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia.
Kevin Kristian Putra, MD: ‡ Neurosurgery Division, Department of Surgery, Faculty of Medicine, Udayana University, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia.
I. Putu Ramanda Suadnyana, MD: From the * Plastic Reconstructive and Aesthetic Surgery Division, Faculty of Medicine, Udayana University, Prof. Dr. I.G..G. Ngoerah General Hospital, Denpasar, Bali, Indonesia

DOI: https://doi.org/10.1097/GOX.0000000000006268
Journal volume & issue: Vol. 12, no. 11
p. e6268

Abstract

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Summary:. The number of spinal reconstruction cases is growing, as are the accompanying complications. Wound complications after spinal reconstruction can be fatal and can affect up to 19% of patients undergoing major spine surgery. The discipline of spinoplastic surgery is characterized by the use of vascularized bone grafts to reconstruct spinal defects, which provide better results compared with nonvascularized and allogenic equivalents, owing to their superior blood supply. We present a 49-year-old man with spinal defect in the C3-C7 region treated with spinoplastic reconstruction. A 5 × 6 cm occipital VBG was designed with a centrally located muscular pedicle and successfully inset into the osseous defect. Radiographs taken 15 months postoperatively demonstrated overall excellent bony fusion, and the patient made an appropriate clinical recovery. In difficult spine procedures, the use of this occipital vascularized bone graft may lead to higher fusion rates without the need for free tissue transfer or allograft placement, which may not be available at all surgical centers around the world.

Published in Plastic and Reconstructive Surgery, Global Open

ISSN: 2169-7574 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://www.prsgo.com

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