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Anterior Cervical Reconstruction Using Free Vascularized Fibular Graft after Cervical Corpectomy.

Addosooki AI, Alam-Eldin M, Abdel-Wanis Mel-S, Yousef MA, Dionigi P, Kenawey MO - Global Spine J (2015)

Bottom Line: Results All patients achieved successful fusion.All patients achieved satisfactory clinical outcome.No neurologic injuries occurred during the operations.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Sohag University Hospital, Sohag, Egypt.

ABSTRACT
Study Design Prospective study. Objective The aim of this study was to evaluate the clinical and radiologic results of using free vascularized fibular graft (FVFG) for anterior reconstruction of the cervical spine following with varying levels of corpectomy. Methods Ten patients underwent anterior cervical reconstruction using an FVFG after cervical corpectomy augmented with internal instrumentation. All patients were evaluated neurologically according to the Japanese Orthopaedic Association (JOA) and modified JOA scoring systems and the Nurick grading system. The neurologic recovery rate was determined, and the clinical outcome was assessed based on three factors: neck pain, dependence on pain medication, and ability to return to work. The fusion status and maintenance of lordotic correction by the strut graft were determined by measuring the lordosis angle and fused segment height (FSH). Results All patients achieved successful fusion. The mean follow-up period was 35.2 months (range, 28 to 44 months). Graft union occurred at a mean of 3.5 months. The mean loss of lordotic correction was 0.95 degrees, and the mean change in FSH was <1 mm. The neurologic recovery rate was excellent in four patients, good in five, and fair in one. All patients achieved satisfactory clinical outcome. No neurologic injuries occurred during the operations. Conclusion The use of FVFG is a valuable and effective technique in anterior cervical reconstruction for complex disorders.

No MeSH data available.


Related in: MedlinePlus

Harvested free fibular graft after being shaped to match the defect size.
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FI1500032-2: Harvested free fibular graft after being shaped to match the defect size.

Mentions: We used the superior thyroid artery in eight patients and the lingual artery in two as the recipient artery, and the venae comitantes or a branch of the external jugular veins as the recipient vein. The FVFG remained attached to its vascular pedicle until the moment of actual transfer. The length of the free fibular graft was accurately measured according to the size of the cervical defect (Fig. 2). We cut the fibula using an electric reciprocating saw while protecting the vascular pedicle at all times. The fibular graft was positioned with the vascular pedicle ending in the cephalic direction and directed to the side of the incision (right or left). The most lateral parts of the vertebral body were not removed during corpectomy to protect the vertebral artery. At the site of exit of the vascular pedicle, the most lateral part of the vertebral body was completely removed to provide passage for the vascular pedicle without compression.


Anterior Cervical Reconstruction Using Free Vascularized Fibular Graft after Cervical Corpectomy.

Addosooki AI, Alam-Eldin M, Abdel-Wanis Mel-S, Yousef MA, Dionigi P, Kenawey MO - Global Spine J (2015)

Harvested free fibular graft after being shaped to match the defect size.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4836930&req=5

FI1500032-2: Harvested free fibular graft after being shaped to match the defect size.
Mentions: We used the superior thyroid artery in eight patients and the lingual artery in two as the recipient artery, and the venae comitantes or a branch of the external jugular veins as the recipient vein. The FVFG remained attached to its vascular pedicle until the moment of actual transfer. The length of the free fibular graft was accurately measured according to the size of the cervical defect (Fig. 2). We cut the fibula using an electric reciprocating saw while protecting the vascular pedicle at all times. The fibular graft was positioned with the vascular pedicle ending in the cephalic direction and directed to the side of the incision (right or left). The most lateral parts of the vertebral body were not removed during corpectomy to protect the vertebral artery. At the site of exit of the vascular pedicle, the most lateral part of the vertebral body was completely removed to provide passage for the vascular pedicle without compression.

Bottom Line: Results All patients achieved successful fusion.All patients achieved satisfactory clinical outcome.No neurologic injuries occurred during the operations.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Sohag University Hospital, Sohag, Egypt.

ABSTRACT
Study Design Prospective study. Objective The aim of this study was to evaluate the clinical and radiologic results of using free vascularized fibular graft (FVFG) for anterior reconstruction of the cervical spine following with varying levels of corpectomy. Methods Ten patients underwent anterior cervical reconstruction using an FVFG after cervical corpectomy augmented with internal instrumentation. All patients were evaluated neurologically according to the Japanese Orthopaedic Association (JOA) and modified JOA scoring systems and the Nurick grading system. The neurologic recovery rate was determined, and the clinical outcome was assessed based on three factors: neck pain, dependence on pain medication, and ability to return to work. The fusion status and maintenance of lordotic correction by the strut graft were determined by measuring the lordosis angle and fused segment height (FSH). Results All patients achieved successful fusion. The mean follow-up period was 35.2 months (range, 28 to 44 months). Graft union occurred at a mean of 3.5 months. The mean loss of lordotic correction was 0.95 degrees, and the mean change in FSH was <1 mm. The neurologic recovery rate was excellent in four patients, good in five, and fair in one. All patients achieved satisfactory clinical outcome. No neurologic injuries occurred during the operations. Conclusion The use of FVFG is a valuable and effective technique in anterior cervical reconstruction for complex disorders.

No MeSH data available.


Related in: MedlinePlus