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Published on: September 16, 2022
Vascularized bone flaps for thoracolumbar spinal fusion
V G Yelizarov1, V K Minachenko, O R Gerasimov
1Clinic of Traumatology, Orthopedics, and Military Surgery, Yaroslavl, Russia.
Annals of Plastic Surgery
|December 1, 1993
Summary
Vascularized bone flaps using deep circumflex iliac artery and quadratus lumborum muscle enhance spinal fusion. These flaps maintain bone density and increase fusion strength, preventing resorption.
Area of Science:
- Orthopedic Surgery
- Spinal Fusion Techniques
- Vascularized Bone Grafts
Background:
- Spinal fusion aims to achieve solid bony union between vertebrae.
- Traditional bone grafts are prone to resorption and may have suboptimal fusion rates.
- Vascularized bone flaps offer a potential solution to improve spinal fusion outcomes.
Observation:
- Dissections on 52 cadavers were performed to develop vascularized bone flaps from the iliac wing.
- The flaps utilized either the quadratus lumborum muscle or the deep circumflex iliac artery.
- Fifteen clinical spinal fusion procedures were successfully performed using these techniques.
Findings:
- Roentgenological evaluation showed no resorption of the vascularized bone flaps.
- These flaps maintained bone density 1.5 to 2 times greater than nonvascularized bone.
- Bone flaps with a dual blood supply demonstrated superior strength in bony fusion.
Implications:
- Vascularized bone flaps represent a promising advancement in spinal fusion surgery.
- These grafts offer enhanced bone stock and potentially higher fusion success rates.
- Further research may explore the long-term benefits and broader applications of this technique.
