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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

(a) Preoperative X-ray; (b, c) preoperative magnetic resonance imaging (T2 and T1); (d) immediately postoperative X-rays; (e) final follow up X-rays showing solid fusion of the graft.
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FI1500032-5: (a) Preoperative X-ray; (b, c) preoperative magnetic resonance imaging (T2 and T1); (d) immediately postoperative X-rays; (e) final follow up X-rays showing solid fusion of the graft.

Mentions: The mean operating time was 6 hours (range, 4.5 to 8 hours), and the mean hospital stay was 7.5 days (range, 5 to 10 days). Uniform enhancement of the FVFG with good vascularity was seen in all patients with gadolinium-enhanced MRI. All patients achieved successful fusion at a mean of 3.5 months (range, 2.5 to 5 months; Fig. 5). The mean follow-up period was 35.2 months (range, 28 to 44 months).


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)

(a) Preoperative X-ray; (b, c) preoperative magnetic resonance imaging (T2 and T1); (d) immediately postoperative X-rays; (e) final follow up X-rays showing solid fusion of the graft.
© Copyright Policy
Related In: Results  -  Collection

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

FI1500032-5: (a) Preoperative X-ray; (b, c) preoperative magnetic resonance imaging (T2 and T1); (d) immediately postoperative X-rays; (e) final follow up X-rays showing solid fusion of the graft.
Mentions: The mean operating time was 6 hours (range, 4.5 to 8 hours), and the mean hospital stay was 7.5 days (range, 5 to 10 days). Uniform enhancement of the FVFG with good vascularity was seen in all patients with gadolinium-enhanced MRI. All patients achieved successful fusion at a mean of 3.5 months (range, 2.5 to 5 months; Fig. 5). The mean follow-up period was 35.2 months (range, 28 to 44 months).

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