Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands; Amsterdam Movement Sciences Research Institute, Amsterdam, The Netherlands.
Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands; Amsterdam Movement Sciences Research Institute, Amsterdam, The Netherlands.
J Plast Reconstr Aesthet Surg. 2022 Feb;75(2):629-640. doi: 10.1016/j.bjps.2021.08.036. Epub 2021 Sep 20.
The use of free vascularized fibula grafts (FVFG) in complex spinal deformity surgery intends to allow for life-long stability of the spine with good long-term clinical outcome. However, these long-term outcomes of this technique are still lacking. The objective of this study is to report the long-term postoperative outcomes and establish the long-term viability of this method for spinal reconstruction.
A retrospective cohort study was conducted in all patients who underwent spinal reconstructive surgery utilizing a FVFG at a tertiary medical centre. Questionnaires taken from the participants were the Numeric Pain Rating Scale (NPRS), Oswestry Low Back Pain Disability (also known as Oswestry Disability Index (ODI)), Scoliosis Research Society 22r (SRS-22), the EQ-5D-5L and a self-assembled questionnaire regarding donor site comorbidities and patient satisfaction.
Over a period of 24 years (1995-2019), we used FVFG for spinal reconstruction in 31 patients. A total of 25 patients were included in this study, 8 patients were deceased at the time of this study, and sixteen patients responded to the questionnaires. Patient satisfaction was rated 6.8 out of 10, the average SRS-22r score was 3.6, EQ-5D-5L score was 0.725, and the ODI score showed a minimal disability (0-20%) postoperatively. Overall complication-free survival was 8.9 years. Nine patients underwent a re-operation in the spinal area; five for the removal of the spinal instrumentation.
Patients reported satisfied and good long-term outcomes following FVFG surgical procedure for complex spinal deformities. Therefore, considering the alternatives, this procedure provides a good long-term solution for complex spinal deformity surgery.
在复杂脊柱畸形手术中使用游离血管化腓骨移植（FVFG）旨在实现脊柱的终身稳定性，并获得良好的长期临床结果。然而，该技术的长期结果仍不明确。本研究的目的是报告长期术后结果，并确定该方法用于脊柱重建的长期可行性。
对在一家三级医疗中心接受 FVFG 脊柱重建手术的所有患者进行回顾性队列研究。向参与者发放了数字疼痛评分量表（NPRS）、Oswestry 下腰痛残疾问卷（也称为 Oswestry 功能障碍指数（ODI））、脊柱侧凸研究协会 22r（SRS-22）、EQ-5D-5L 以及一份关于供体部位合并症和患者满意度的自拟问卷。
在 24 年的时间里（1995-2019 年），我们使用 FVFG 对 31 例患者进行了脊柱重建。本研究共纳入 25 例患者，8 例患者在研究时已死亡，16 例患者对问卷做出了回应。患者满意度评分为 10 分中的 6.8 分，SRS-22r 平均得分为 3.6，EQ-5D-5L 评分为 0.725，ODI 评分显示术后功能障碍程度轻微（0-20%）。总体无并发症生存时间为 8.9 年。9 例患者在脊柱区域进行了再次手术，其中 5 例为移除脊柱内固定装置。
FVFG 手术治疗复杂脊柱畸形的患者报告满意度高且长期预后良好。因此，考虑到替代方案，该手术为复杂脊柱畸形手术提供了一种良好的长期解决方案。
