title: Donor-site complications of autogenous nonvascularized fibula strut graft harvest for anterior cervical corpectomy and fusion surgery: experience with 163 consecutive cases.
abstract: BACKGROUND
  The fibula is a source of bone graft for reconstruction of the appendicular and axial skeleton.
  
  
  OBJECTIVE
  The aim of this study is to determine donor-site complications and morbidity in a large series of patients who underwent autogenous fibula harvesting for anterior cervical corpectomy and fusion (ACCF) surgery.
  
  
  METHODS
  Retrospective review (Level III).
  
  
  METHODS
  One hundred sixty-three patients over an eight-year period who underwent ACCF with autogenous fibula.
  
  
  METHODS
  Donor site complications (such as infection, cellulitis, pain, damage to the superficial peroneal nerve, ankle instability, tibial stress fracture, and so forth), treatment, and final outcome were determined from patient records.
  
  
  METHODS
  Retrospective study of patients who underwent ACCF with autogenous nonvascularized fibula strut graft over an eight-year period (from 1995 to 2002) was conducted. Donor site complications (such as infection, cellulitis, pain, damage to the superficial peroneal nerve, ankle instability, tibial stress fracture, and so forth), treatment, and final outcome were determined from patient records.
  
  
  RESULTS
  One hundred sixty-three patients underwent ACCF with autogenous fibula graft during the study period. The most common short-term complication (lasting <3 months) was incisional pain, present in 86 of 163 patients (53%). Incisional pain lasted longer than 3 months in 25 of 163 patients (15%) but resolved in all but two patients by 24 months. Two patients (1.2%) developed superficial peroneal neuromas. Five patients (3%) developed tibial stress fractures. Two patients (1.2%) developed ankle instability. Fifteen (9%) patients developed cellulitis that resolved in all patients after a short course of oral antibiotics, with one additional patient developing a deep infection requiring surgical debridement and intravenous antibiotics.
  
  
  CONCLUSIONS
  Although autogenous fibula is an excellent graft for multilevel ACCF reconstruction, surgeons should carefully consider the associated morbidity of fibular harvest before surgery. In this series, most complications were of short duration. However, nine patients with long-term complications required five additional surgical procedures. Therefore, patients who are scheduled to undergo autogenous fibula harvest should be advised about these potential complications.
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55902, USA. nassr.ahmad@mayo.edu
authors.forename: Ahmad
authors.initials: A
authors.lastname: Nassr
authors.forename: Mustafa H
authors.initials: MH
authors.lastname: Khan
authors.forename: Mir H
authors.initials: MH
authors.lastname: Ali
authors.forename: Michael T
authors.initials: MT
authors.lastname: Espiritu
authors.forename: Steven E
authors.initials: SE
authors.lastname: Hanks
authors.forename: Joon Y
authors.initials: JY
authors.lastname: Lee
authors.forename: William F
authors.initials: WF
authors.lastname: Donaldson
authors.forename: James D
authors.initials: JD
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation / Q000009:adverse effects*; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D005360:Fibula / Q000601:surgery* / Q000637:transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*