Abstract: Vascularized free fibular grafts have been described previously for use with spinal reconstruction in cases of osteoporosis, tumor, kyphosis, and spondylolisthesis. After evaluating our experience with the use of vascularized free fibular grafts in augmenting spinal reconstruction for infection, trauma, and tumor, we found that our results reaffirm this to be a safe and successful choice in the armamentarium of spine surgery.

Methods: We retrospectively reviewed the charts of a nine year period at our institution in which seven patients received a vascularized free fibular graft as part of their spinal reconstruction.

Results: There were four men and three women whose ages ranged from 14-58 years (mean 45years). Six out of the seven patients presented with lower back pain. Three of the patients were smokers. While all patients had preoperative radiographs, an additional 6/7 had an MRI. The harvested fibular length ranged from 15-25cm (mean, 21cm). From one to six (mean, two)vertebral levels were spanned. Graft fusion was confirmed in four patients radiographically from 12 to 40 months (mean, 22.5 months). Postoperatively, all patients were mobile at last follow-up.

Conclusion: Vascularized free fibular transfer for spinal fusion may provide a means of improving union rates in difficult reconstructive settings.