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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

Preoperative and postoperative mean of neurologic scores. Abbreviation: JOA, Japanese Orthopaedic Association.
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FI1500032-6: Preoperative and postoperative mean of neurologic scores. Abbreviation: JOA, Japanese Orthopaedic Association.

Mentions: Three patients showed excellent clinical outcome, and the remaining 7 had good clinical outcome. After surgery, the neurologic status improved in all cases (Fig. 6), and no neurologic deterioration was observed in any of the cases. The mean postoperative JOA, modified JOA, and Nurick scores were 14.5, 15.5, and 1.7, respectively. Statistical analysis of the differences between the preoperative and postoperative JOA, modified JOA, and Nurick scores was performed using Wilcoxon signed rank test and was found to be statistically significant (P = 0.004, 0.005, and 0.007, respectively). The neurologic recovery rate was excellent in 4 patients, good in 5, and fair in 1 (Table 3). No neurologic injuries or other complications occurred during the intervention. Early complications included serous discharge from the cervical wound in 1 patient, which closed after 2 weeks of antibiotic administration. Late complications included pullout of the locked plate's lower screws, despite successful fusion, in 1 patient at 44 months and adjacent segment degeneration of the C5–C6 in another patient at 36 months. Graft dislodgment or pseudarthrosis was not observed. Delayed wound healing with superficial wound infection was observed in one patient, which was controlled with antibiotic therapy. Another patient complained of residual donor site pain for 4 months after the intervention. Otherwise, there was no neurologic or functional impairment.


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)

Preoperative and postoperative mean of neurologic scores. Abbreviation: JOA, Japanese Orthopaedic Association.
© Copyright Policy
Related In: Results  -  Collection

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

FI1500032-6: Preoperative and postoperative mean of neurologic scores. Abbreviation: JOA, Japanese Orthopaedic Association.
Mentions: Three patients showed excellent clinical outcome, and the remaining 7 had good clinical outcome. After surgery, the neurologic status improved in all cases (Fig. 6), and no neurologic deterioration was observed in any of the cases. The mean postoperative JOA, modified JOA, and Nurick scores were 14.5, 15.5, and 1.7, respectively. Statistical analysis of the differences between the preoperative and postoperative JOA, modified JOA, and Nurick scores was performed using Wilcoxon signed rank test and was found to be statistically significant (P = 0.004, 0.005, and 0.007, respectively). The neurologic recovery rate was excellent in 4 patients, good in 5, and fair in 1 (Table 3). No neurologic injuries or other complications occurred during the intervention. Early complications included serous discharge from the cervical wound in 1 patient, which closed after 2 weeks of antibiotic administration. Late complications included pullout of the locked plate's lower screws, despite successful fusion, in 1 patient at 44 months and adjacent segment degeneration of the C5–C6 in another patient at 36 months. Graft dislodgment or pseudarthrosis was not observed. Delayed wound healing with superficial wound infection was observed in one patient, which was controlled with antibiotic therapy. Another patient complained of residual donor site pain for 4 months after the intervention. Otherwise, there was no neurologic or functional impairment.

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