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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

Plain X-ray lateral extension and flexion views showing solid fusion extending from C4 to C7.
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FI1500032-3: Plain X-ray lateral extension and flexion views showing solid fusion extending from C4 to C7.

Mentions: The anteroposterior, lateral, and flexion–extension lateral radiographs of all the patients were evaluated by an independent and experienced radiologist. The status of fusion and maintenance of lordotic correction by the strut graft were determined by measuring the lordosis angle and fused segment height (FSH) at discharge and final follow-up.19 Radiographic fusion was defined as an absence of motion across the operated level on lateral flexion–extension radiographs and an absence of lucent lines or presence of bridging bony trabeculae at the fibula strut–vertebral body interface (Fig. 3).161920 The lordosis angle was determined from the tangent of the posterior body line between the C2 and C7. The FSH was assessed by measuring the distance between the anterior–superior angle of adjacent vertebrae above and the anterior–inferior angle of adjacent vertebrae below (height of the anterior border) and measurement of the distance between the posterior–superior angle of adjacent vertebrae above and the posterior–inferior angle of adjacent vertebrae below (height of the posterior border). The FSH was calculated as the mean value of height of the anterior border and height of the posterior border (Fig. 4).19 Computed tomography was used to confirm the diagnosis of fusion. Gadolinium-enhanced MRI was performed in all patients 2 weeks postoperatively to confirm the perfusion and vascularity of the fibular graft.21 We used Wilcoxon signed rank test for statistical analysis of the difference between the preoperative and postoperative neurologic scores with the level of significance set at P < 0.05.


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)

Plain X-ray lateral extension and flexion views showing solid fusion extending from C4 to C7.
© Copyright Policy
Related In: Results  -  Collection

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

FI1500032-3: Plain X-ray lateral extension and flexion views showing solid fusion extending from C4 to C7.
Mentions: The anteroposterior, lateral, and flexion–extension lateral radiographs of all the patients were evaluated by an independent and experienced radiologist. The status of fusion and maintenance of lordotic correction by the strut graft were determined by measuring the lordosis angle and fused segment height (FSH) at discharge and final follow-up.19 Radiographic fusion was defined as an absence of motion across the operated level on lateral flexion–extension radiographs and an absence of lucent lines or presence of bridging bony trabeculae at the fibula strut–vertebral body interface (Fig. 3).161920 The lordosis angle was determined from the tangent of the posterior body line between the C2 and C7. The FSH was assessed by measuring the distance between the anterior–superior angle of adjacent vertebrae above and the anterior–inferior angle of adjacent vertebrae below (height of the anterior border) and measurement of the distance between the posterior–superior angle of adjacent vertebrae above and the posterior–inferior angle of adjacent vertebrae below (height of the posterior border). The FSH was calculated as the mean value of height of the anterior border and height of the posterior border (Fig. 4).19 Computed tomography was used to confirm the diagnosis of fusion. Gadolinium-enhanced MRI was performed in all patients 2 weeks postoperatively to confirm the perfusion and vascularity of the fibular graft.21 We used Wilcoxon signed rank test for statistical analysis of the difference between the preoperative and postoperative neurologic scores with the level of significance set at P < 0.05.

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