Vascularized Occipital Bone Grafting: Indications, Techniques, Clinical Outcomes, and Alternatives

Sebastian J. Winocour; Erica Y. Xue; Michael A. Bohl; Farrokh Farrokhi; Matthew J. Davis; Amjed Abu-Ghname; Alexander E. Ropper; Edward M. Reece

doi:10.1055/s-0041-1723834

Seminars in Plastic Surgery, Table of Contents

Semin Plast Surg 2021; 35(01): 014-019
DOI: 10.1055/s-0041-1723834

Review Article

Vascularized Occipital Bone Grafting: Indications, Techniques, Clinical Outcomes, and Alternatives

Sebastian J. Winocour

¹Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas

,

Erica Y. Xue

¹Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas

²Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas

,

Michael A. Bohl

³Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona

,

Farrokh Farrokhi

⁴Department of Neurosurgery, Virginia Mason Hospital, Seattle, Washington

,

Matthew J. Davis

¹Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas

²Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas

,

Amjed Abu-Ghname

¹Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas

²Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas

,

Alexander E. Ropper

⁵Department of Neurosurgery, Baylor College of Medicine, Houston, Texas

,

Edward M. Reece

¹Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas

²Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas

⁵Department of Neurosurgery, Baylor College of Medicine, Houston, Texas

› Author Affiliations

Abstract

Successful arthrodesis at the craniocervical junction and atlantoaxial joint can be more challenging than in other segments of the cervical spine. Different techniques for spinal fixation in this region have been well described, along with auxiliary methods to improve fusion rates. The occipital vascularized bone graft is a novel technique that can be used to augment bony arthrodesis in the supra-axial cervical spine. It provides the benefits of a vascularized autologous graft, such as accelerated healing, earlier fusion, and increased strength. This technique can be learned with relative ease and may be particularly helpful in cases with high risk of nonunion or pseudoarthrosis in the upper cervical spine.

Keywords

vascularized bone graft - spinoplastic reconstruction - occipital graft - autograft - spinal fusion

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References

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