Anterior fibular strut grafting in the treatment of kyphosis.

An intact segment of autologous fibula provides a strong, physiologic, anterior support in the surgical treatment of short segment kyphosis. In this series of 20 patients, only 3 had no signs of spinal cord injury. Correction averaged 20 degrees. At an average follow-up of 2.2 years, 9 degress of the previously obtained correction were maintained, including 3 patients with non-union and marked loss of correction. Twenty-four complications were noted in association with traction, surgery, and immobilization. The results suggest that attempts at correction should remain secondary to those of stabilization and relief or prevention of neurologic problems. Supplementary posterior spinal fusion is necessary to increase the strength of the stabilized segment as well as decrease the incidence of pseudoarthrosis and loss of correction.