{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:36:54Z","timestamp":1786988214687,"version":"build-2736575974"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Cervical spine reconstruction is essential following en bloc tumor resections, particularly in defects exceeding four centimeters. Traditional mechanical solutions or non\u2010vascularized grafts are often suboptimal, with complications such as non\u2010union, infections, and instability. The vascularized osteoadipofascial fibular flap offers a durable alternative with structural and biological benefits. We present the case of a 55\u2010year\u2010old woman with an 8\u2010month history of cervicobrachialgia and left upper limb paresis. Imaging revealed a 7\u2010cm lesion spanning C4\u2013T1 with foraminal infiltration, and histopathology confirmed a chordoma. A two\u2010stage surgery was performed: posterior stabilization and partial tumor resection, followed by anterior corpectomies (C5, C6, C7) and reconstruction with a vascularized fibular flap. The flap was anastomosed to the superior thyroid vessels, and its adipofascial component isolated the esophagus from the anterior cervical plate. Postoperative proton therapy was administered. Postoperative recovery was uneventful, with a 10\u2010day hospital stay. At 24\u2009months, the patient showed no recurrence, complete symptom resolution, and stable osteosynthesis with evidence of bone callus formation at graft\u2010vertebra junctions. This case suggests that vascularized fibular reconstruction may provide reliable structural support and biological integration in complex cervical oncologic defects.<\/jats:p>","DOI":"10.1002\/micr.70230","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T11:23:37Z","timestamp":1776684217000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cervical Spine Reconstruction With Vascularized Osteoadipofascial Fibular Flap and Periosteum Extension After Chordoma Resection and Adjuvant Proton Therapy: A Case Report"],"prefix":"10.1002","volume":"46","author":[{"given":"Javier","family":"Buend\u00eda P\u00e9rez","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Cl\u00ednico San Carlos Hospital  Madrid 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