The Use of a Rib Vascularized Bone Graft in Revision Vertebral Column Resection for a Complex Pediatric Spine Patient.

Abstract

We report a case of a 9-year, 10-month-old female patient who ultimately required a revision vertebral column resection to manage a progressive congenital kyphoscoliosis complicated by postoperative surgical site infection, decubiti and implant exposure, proximal junctional kyphosis, and pseudarthrosis. Definitive surgery consisted of T4-L4 posterior spinal fusion and revision vertebral column resection with a pedicled rib vascular bone graft. At 3-year follow-up, the patient was fully recovered with return to full noncontact activities. The purpose of this case report is to describe the use of a rib vascular bone graft to increase the likelihood of arthrodesis for a complex pediatric spinal fusion patient with deficient posterior elements and multiple failed surgeries.