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Methods@#This study included 42 patients with ASD (two men and 40 women; 112 segments; mean, 68.5±8.4 years; and mean follow-up, 31.6±17.0 months) who underwent LIF and posterior correction surgery. The concave slot of the LIF cage was filled with an autologous iliac crest bone graft (IBG), and the convex slot with a porous hydroxyapatite/collagen (HAp/Col) composite was soaked with bone marrow aspirate. Endplate injury, the gap between vertebral endplate and cage in the coronal or sagittal plane, and fusion status were evaluated using computed tomography multiplanar reconstruction at 12 months after surgery. Moreover, the associated risk factors for pseudoarthrosis were analyzed. @*Results@#Fusion at LIF segments were observed in 71.4% segments at 12 months after surgery. Fusion on the concave slot (autologous IBG side), convex slot (porous HAp/Col composite side), and both concave and convex slots were observed in 66.1%, 37.5%, and 36.6% of patients, respectively. Moreover, pseudoarthrosis was observed in 28.6% at 12 months after surgery. Consequently, logistic regression analysis of the fusion at the LIF segment revealed that the gap between the LIF cage and endplate in the coronal plane (p=0.030; odds ratio, 0.183; 95% confidence interval, 0.030–0.183) was significantly associated with pseudoarthrosis at the LIF segments. @*Conclusions@#ASD surgery fusion rate using LIF cages was 71.4% at 12 months after surgery. The fusion rate was higher on the concave slot filled with autologous IBG than on the convex slot filled with a porous HAp/Col composite. The gap in the coronal plane was a risk factor for pseudoarthrosis at the LIF segment.
RESUMO
OBJECTIVE: Ectopic implantation was first reported by Godina in 1986. We herein present 2 cases in which amputated fingers were salvaged and reconstructed by means of temporary ectopic implantation utilizing perforator anastomoses and chimeric flaps. METHODS: Case 1. A 30-year-old man injured his right hand. All of the fingers were completely crushed with the exception of the little finger. We performed an ectopic implantation by using the superficial circumflex iliac artery perforator. Three months later, the little finger was transplanted with the superficial circumflex iliac artery perforator flap, vascularized nerve, and the 2nd metacarpal bone. Case 2. A 29-year-old man suffered a degloving injury of the index finger. The digital artery was anastomosed to deep inferior epigastric artery perforator. One month later, a deep inferior epigastric artery perforator flap containing the ectopically transplanted index finger was transplanted, but the index fingertip became pale and necrotized. After debridement, a hemipulp transplantation was performed. RESULTS/CONCLUSIONS: As the diameter of perforators is similar to that of digital arteries, and perforators are capable of supplying large areas of tissue, they can be used as recipient vessels for ectopic implantation in finger salvage procedures. Another advantage of perforators as feeding vessels in ectopic implantation is the possibility of forming an ectopic chimera; the finger can be incorporated as a part of the chimeric reconstructive flap. With respect to these advantages, the perforator can be used as a feeder in an ectopic implantation of single finger.
