• Joshua J Goldman, Kristine A Huynh, Wissam Elfallal, Kongkrit Chaiyasate, and Daniel K Fahim.
• Division of Plastic Surgery, Department of Surgery, University of Nevada, Las Vegas School of Medicine, Las Vegas, Nevada, USA.
• World Neurosurg. 2020 Dec 1; 144: 34-38.

BackgroundLong-term stabilization of the cervical spine after extensive multilevel tumor resection is difficult to achieve. The current standard approach of instrumentation combined with allograft or nonvascularized autograft is limited in settings of increased risk of nonunion or delayed union (i.e., prior radiation therapy or poorly vascularized wound beds).Case DescriptionWe report the first time to our knowledge that a vascularized fibular free flap has been used to reconstruct the cervical column across 5 vertebral levels, from the craniocervical junction to the lower cervical spine. We describe a transoral approach to the area and compare this method with other reconstructive options.ConclusionsVascularized bone grafting is a viable alternative to achieve lasting stability because of hastened fusion time, limited reliance on osseous remodeling, and incorporation into the axial skeleton with strut strength.Copyright © 2020 Elsevier Inc. All rights reserved.

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