Transverse Rectus Abdominis Muscle Flow-Through to Free Fibula Flap for Lumbar Spinal Reconstruction in a Pediatric Patient: A Case Report

Neal G. Moores, Jessica Luo, Giovanna Pires, Whitney Moss, Scott Short, Robert J. Bollo, R. Lor Randall, Jayant P. Agarwal

Research output: Contribution to journalArticlepeer-review

Abstract

Case:A 7-week-old girl presented with a recurrent primitive myxoid mesenchymal tumor of infancy requiring extensive resection of lower back musculature, L3-S2 vertebral bodies, and left L5 nerve root. Reconstruction consisted of transverse rectus abdominis muscle (TRAM) flow-through to free fibular flap to reconstruct the bony defect and fill the soft-tissue void. One-year postoperative imaging revealed a well-incorporated fibula graft. At the 30-month follow-up, the patient can bear weight on the autograft while sitting upright, allowing for efficient ambulation with a wheelchair.Conclusion:TRAM flow-through to free fibular flap is an efficacious reconstructive method for a multilevel vertebral spinal defect in a pediatric patient.

Original languageEnglish (US)
JournalJBJS Case Connector
Volume12
Issue number1
DOIs
StatePublished - Feb 24 2022
Externally publishedYes

Keywords

  • female
  • free vascularized fibular flap
  • infant
  • PMMTI
  • primitive myxoid mesenchymal tumor of infancy
  • spinal reconstruction
  • TRAM flow-through flap

ASJC Scopus subject areas

  • Medicine(all)

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