Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Reconstruction of the cervical spine with two osteocutaneous fibular flap after radiotherapy and resection of osteoclastoma: a case report

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Hematoma and deep surgical site infection following primary breast augmentation: A retrospective review of 1128 patients

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Perfusion changes in the foot after a free fibula flap

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

  3. Enhanced recovery after breast reconstruction with a pedicled Latissimus Dorsi flap-A prospective clinical study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Hematoma and deep surgical site infection following primary breast augmentation: A retrospective review of 1128 patients

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Surgical management of rhinocerebral mucormycosis: A case series

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Perfusion changes in the foot after a free fibula flap

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

  4. An observational study comparing the SPY-Elite® vs. the SPY-PHI QP System in breast reconstructive surgery

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer
Transfer of a vascularised free fibular bone for reconstruction of the cervical spine has been described previously.(1-4) However, this is the first report of a reconstruction with both an osteocutaneous fibular flap for anterior stabilisation and a double-islanded osteocutaneous fibular flap for posterior stability. We present a case of an osteoclastoma in C2 initially treated with radiotherapy 1.8 Gy × 30. Two months after radiotherapy, the patient developed severe osteoradionecrosis and luxation of C2 causing neurological impairment. The patient was treated with cervical traction for 10 days. Resection of C2 was performed through a posterior approach and a secondary transoral approach. The spine was stabilised from a posterior approach using allografts and a titanium plate and rod construct (Vertex) from the occipital squama to C5 and from an anterior approach with allograft filled cage from C1 to C3. Two months later, rupture of the pharyngeal wall was noted with exposure of the anterior cage. A few days later, the posterior scar ruptured. The anterior cage was removed and the pharyngeal wall was sutured. Revision of the posterior wound was performed, leaving the implants in place. To secure stability of the spine, the patient was treated with a HALO. Once again, the pharyngeal wall ruptured. Reconstruction of the posterior pharyngeal wall and the anterior column of the spine was performed with an osteocutaneous fibular flap from the skull base to C3. Five months later, a computed tomography (CT) scan showed insufficient bony fusion of both anterior and posterior bone grafts, and the posterior wound had not healed. A second osteocutaneous fibular flap was placed bilaterally from the occipital squama to the posterior elements of Th1, closing the wound defect. Apart from the occipital squama, fusion was seen at all sites after 14 months, and the HALO was removed.
OriginalsprogEngelsk
TidsskriftJournal of Plastic, Reconstructive & Aesthetic Surgery (Print Edition)
Vol/bind65
Udgave nummer9
Sider (fra-til)1262-4
Antal sider3
ISSN1748-6815
DOI
StatusUdgivet - 2012

ID: 36802954