Reconstruction of an extensive upper back defect following excision of chondrosarcoma using bilateral trapezius muscle and bilateral bipedicle fasciocutaneous flaps: A case report

Introduction and importance

Chondrosarcoma (CS) is a rare malignant cartilage-forming tumor, with spinal involvement accounting for less than 10 % of cases. Surgical resection often leaves large soft tissue and bony defects that require complex reconstruction.

Case presentation

A 46-year-old female presented with progressive upper back pain. Imaging revealed a 10 cm lesion involving the T4 vertebra, confirmed as chondrosarcoma on biopsy. Wide en bloc resection was performed, resulting in a large soft tissue defect. Reconstruction was done using the remaining trapezius muscle to fill the dead space and bilateral bipedicle fasciocutaneous flaps were used for soft tissue coverage.

Clinical discussion

Muscle flaps are commonly used for spinal reconstruction; however, fasciocutaneous flaps offer reliable coverage, better functional outcomes, and reduced complication rates. In this case, a bilateral bipedicle fasciocutaneous flap provided effective coverage where the trapezius muscle was inadequate alone.

Conclusion

Bilateral bipedicle fasciocutaneous flaps combined with remnant muscle tissue offer a safe and effective reconstructive option for large upper back defects following spinal chondrosarcoma resection.