Correction of a Dystrophic Cervicothoracic Spine Deformity in Recklinghausen's Disease

The use of vascularized fibular grafts for the reconstruction of spinal and sacral defects

“…26,27 There are additional reports of successful multilevel anterior cervical fusion using vascularized free fibular grafts for spinal deformities due to neurofibromatosis and congenital defects, with bony union occurring at 6 weeks, 4 months, and 5 months, respectively. 23,24,36 Kaneda reported on four patients with structural kyphosis who were stabilized anteriorly with vascularized free fibular strut grafts. No complications occurred and bony union was observed in all patients by 3 months postoperatively.…”

The Role of Vascularized Bone Grafts in Spine Surgery

“…Two or three vertebral levels were fused in all patients, with an average time to bony union of 3.4 months [32,33]. There are additional reports of successful multilevel anterior cervical fusion using vascularized free fibular grafts for spinal deformities that were due to neurofibromatosis and congenital defects, with robust bony union occurring at 6 weeks, 4 months, and 5 months [29,30,42]. Kaneda and colleagues [35] reported on 4 patients who had structural kyphosis who were stabilized anteriorly with vascularized free fibular strut grafts.…”

Free vascularized bone graft in spinal surgery: indications and outcome in eight cases

“…A 14-year-old boy with known neurofibromatosis had a progressive dysplastic cervicothoracic kyphoscoliosis deformity and instability [30]. At presentation the patient was wheelchair dependent, had severe neck pain, progressive pyramidal tract signs and intermittent right arm paresis.…”

“…Preoperative halo traction was performed to prevent further deterioration, to redress the deformity gradually, and to order special implants. A staged procedure was performed: first a dorsal stabilization of occiput -T8 using special implants followed by an anterior fibular strut graft interposition between C2 and C7 [30]. The postoperative period was uneventful; radiologically assessed incorporation of the graft could be seen after 6 weeks.…”

“…Complex progressive symptomatic spinal deformities associated with local changes in structural integrity and weakening of the biomechanical support may require an anterior, a posterior or sometimes a combined approach, using both instrumentation and bone graft to achieve correction, stabilization and fusion [10,30,33,37]. To facilitate fusion, autogenous bone graft is used most often and the results are well known [5,12,22,26,27].…”