Spinoplastic surgical intervention for the treatment of complex spinal disorders and cancer: An initial cohort of 30 vascularized bone grafts.

Abstract

Complex spinal reconstruction carries high risks for wound and fusion complications. Spinoplastic techniques using vascularized bone grafts may expand the plastic surgeon's role beyond soft-tissue closure. In this study we report outcomes from an initial cohort. Single-center retrospective chart review of spinal reconstructions between October 2022 and November 2024 was conducted. Primary outcomes included patient symptoms, wound complications, drain output, operative time, and need for revision surgery. Descriptive statistics were utilized to summarize patient outcomes. Descriptive statistics and univariate comparisons were performed against a non-vascularized bone graft control cohort. A total of 30 vascularized bone grafts were performed in 18 patients. A control cohort of 18 patients was identified for comparison. No statistically significant differences were observed between vascularized bone graft and non-vascularized bone graft cohorts in terms of length of hospital stay (p = 1.00), operative time (p = 0.204), or estimated blood loss (p = 0.330). At the time of most recent follow-up, 14 patients (77.8%) reported substantial improvement with regards to pain, three reported stable symptoms, and one patient experienced worsening of symptoms at the most recent follow-up visit. The use of VBGs was associated with a low complication rate and high rates of subjective patient functional improvement. Furthermore, their use does not lead to significantly increased operating room time, intraoperative blood loss, or hospitalization length when compared to a control cohort undergoing similar surgeries without their use. Vascularized bone grafts appear to be a safe and useful adjunct to augment complex spinal surgeries and promote high-quality patient outcomes.