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Novel Approach to Difficult Spinal Reconstruction: Bilateral Simultaneous Rib and Iliac Crest Vascularized Bone Graft Spinoplastic Surgery – Lumbar Fusion

Day Case Lumbar Fusion Surgery

The article discusses the use of pedicled vascularized bone grafts (VBGs) as a novel approach to augment spinal fusion surgery in patients with pseudoarthrosis, a severe complication with high occurrence rates. The case study involves a 68-year-old woman with distal junctional kyphosis and severe positive sagittal balance who underwent bilateral rib and iliac crest VBG spinoplastic surgery to improve spinal fusion. The two-stage surgical treatment resulted in functional improvement, allowing the patient to maintain an upright posture and walk without complications or graft-related issues at the three-month follow-up. The study concludes that the utilization of pedicled VBGs is a promising technique for enhancing spinal surgery outcomes in high-risk patients

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most established spinal facility in the world

Published article

Pseudoarthrosis is a severe complication of spinal fusion surgery with occurrence rates as high as 35%-40%. Current options of revision surgery to correct pseudoarthrosis frequently carry high failure rates and risk of developing junctional kyphosis. Pedicled vascularized bone grafts (VBGs) are an innovative approach to boost spinal fusion rates via improving structural integrity and increasing the delivery of blood to the donor site. This versatile technique can be performed at different spinal…

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Plast Reconstr Surg Glob Open. 2024 Apr 8;12(4):e5656. doi: 10.1097/GOX.0000000000005656. eCollection 2024 Apr. ABSTRACT Pseudoarthrosis is a severe complication of spinal fusion surgery with occurrence rates as high as 35%-40%. Current options of revision surgery to correct pseudoarthrosis frequently carry high failure rates and risk of developing junctional kyphosis. Pedicled vascularized bone grafts (VBGs) are,

Plast Reconstr Surg Glob Open. 2024 Apr 8;12(4):e5656. doi: 10.1097/GOX.0000000000005656. eCollection 2024 Apr.

ABSTRACT

Pseudoarthrosis is a severe complication of spinal fusion surgery with occurrence rates as high as 35%-40%. Current options of revision surgery to correct pseudoarthrosis frequently carry high failure rates and risk of developing junctional kyphosis. Pedicled vascularized bone grafts (VBGs) are an innovative approach to boost spinal fusion rates via improving structural integrity and increasing the delivery of blood to the donor site. This versatile technique can be performed at different spinal levels without additional skin incisions and with minimal added operative time. Here we present the first bilateral rib and iliac crest VBG spinoplastic surgery performed to augment spinal fusion in a 68-year-old woman with distal junctional kyphosis and severe positive sagittal balance with low back and neck pain and significant difficulty standing upright. The patient had history of multiple spinal operations with preoperative CT imaging demonstrating loosening and pull out of L3 and fracture of L2 screws. She underwent two-stage surgical treatment involving anterior lumbar interbody fusion L3-S1 followed by removal of hardware, T4 to pelvis fusion with L2-3 prone lateral interbody fusion, and T11-S1 posterior column osteotomies. The surgery was augmented by bilateral rib and iliac crest VBGs performed by plastic surgery. At three-month follow-up the patient demonstrated functional improvement, being able to maintain upright posture and walk; was satisfied with the result of the surgery; and demonstrated no graft-related complications. In , utilization of pedicled VBGs is a novel, promising approach to augment spinal surgery in high risk patients.

PMID:38596584 | PMC:PMC11000760 | DOI:10.1097/GOX.0000000000005656

The London Spine Unit : most established spinal facility in the world

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Novel Approach to Difficult Spinal Reconstruction: Bilateral Simultaneous Rib and Iliac Crest Vascularized Bone Graft Spinoplastic Surgery

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Plast Reconstr Surg Glob Open. 2024 Apr 8;12(4):e5656. doi: 10.1097/GOX.0000000000005656. eCollection 2024 Apr. ABSTRACT Pseudoarthrosis is a severe complication of spinal fusion surgery with occurrence rates as high as 35%-40%. Current options of revision surgery to correct pseudoarthrosis frequently carry high failure rates and risk of developing junctional kyphosis. Pedicled vascularized bone grafts (VBGs) are

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