Recipient Vessels for Spine and Posterior Trunk Reconstruction

The regions of the spine and posterior trunk are technically demanding locations for microvascular free tissue transfer. Notably, there is a paucity of adequate recipient vessels in this anatomic area, a uniquely challenging feature that necessitates either a long flap pedicle or a vein graft, should adequate vessels not be identified in close proximity. Whereas soft tissue is typically needed to cover exposed hardware or bone along the posterior trunk, the most common indication for free tissue transfer at the spine/vertebral column is for vascularized bone. Such bony defects typically result from en bloc tumor extirpations, extensive osteomyelitis, or failed bony fusions.