Simultaneous reconstruction of the posterior pharyngeal wall and cervical spine with a free vascularized fibula osteocutaneous flap

We present long-term follow-up of composite reconstruction of the posterior pharyngeal wall and cervical spine with a fibula osteocutaneous free flap. The life-threatening soft-tissue and osseous defect resulted from biopsy and primary radiation therapy for a squamous cell carcinoma of the posterior pharynx, complicated by cervical spine radionecrosis, osteomyelitis, and an epidural abscess. The one-stage reconstruction was successful in restoring cervical spine stability and pharyngeal and laryngeal integrity and function.