Anterior Cervical Reconstruction Using Free Vascularized Fibular Graft after Cervical Corpectomy.
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.
Department of Orthopedic Surgery, Sohag University Hospital, Sohag, Egypt.
Ahmad Ibraheem
AI
Addosooki
Department of Orthopedic Surgery, Sohag University Hospital, Sohag, Egypt.
Mohamed
M
Alam-Eldin
Department of Orthopedic Surgery, Sohag University Hospital, Sohag, Egypt.
Mohamed El-Sayed
Mel-S
Abdel-Wanis
Department of Orthopedic Surgery, Sohag University Hospital, Sohag, Egypt; Experimental Surgery and Microsurgery Research Unit, Department of Clinical Surgical Science, University of Pavia, Pavia, Italy.
Mohamed Abdelhamid Ali
MA
Yousef
Experimental Surgery and Microsurgery Research Unit, Department of Clinical Surgical Science, University of Pavia, Pavia, Italy.
Paolo
P
Dionigi
Department of Orthopedic Surgery, Sohag University Hospital, Sohag, Egypt.
Mohamed Omar
MO
Kenawey
cervical corpectomy; cervical fusion; free vascularized fibular graft; microsurgical reconstruction