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Using segmental renal artery as recipient artery for spinal reconstructive surgery.
Yu-Hsiu Yen1, Teh-Sheng Hsieh, Shaw-Min Hou
1Department of Plastic Surgery, Cathay General Hospital Hsinchu, Hsinchu, Taiwan.
Spine
|November 25, 2010
Summary
This study reports a successful spinal reconstruction using a segmental renal artery for a patient with severe osteomyelitis. The procedure restored mobility and maintained normal kidney function, offering a viable option for complex cases.
Area of Science:
- Vascular surgery techniques
- Spinal reconstruction and fusion
- Management of complex spinal infections
Background:
- Spinal osteomyelitis presents challenges, particularly after repeated surgeries, due to scarring and compromised recipient vessels.
- Vascularized fibular flaps improve bone union rates in spinal reconstruction, especially in poorly perfused areas.
Observation:
- A 49-year-old male with T12-L1 vertebral osteomyelitis and progressive spinal cord involvement underwent a two-stage surgical reconstruction.
- The reconstruction involved posterior spinal fusion followed by anterior debridement and a free vascularized fibular graft.
Findings:
- Vascular anastomosis was successfully performed between the peroneal artery and the left renal artery's segmental artery.
- Over 50 months post-surgery, the patient achieved excellent bony union, regained mobility without assistive devices, and maintained normal renal function.
Implications:
- Segmental renal arteries can serve as viable recipient vessels for spinal reconstruction without compromising kidney function.
- This approach, utilizing vascularized fibular flaps and staged surgery, offers a promising solution for recalcitrant spinal osteomyelitis, improving stability and union rates while minimizing infection risk.
