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Anterior Column Reconstruction with Vascularized Rib After Thoracic Spondylectomy

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Case: A 35-year-old man with a chondrosarcoma of the thoracic spine was treated with neoadjuvant proton radiotherapy (RT), total en bloc spondylectomy (TES), and adjuvant RT. Multiple vertebrae were removed… Click to show full abstract

Case: A 35-year-old man with a chondrosarcoma of the thoracic spine was treated with neoadjuvant proton radiotherapy (RT), total en bloc spondylectomy (TES), and adjuvant RT. Multiple vertebrae were removed to ensure negative margins, which created a sizable midthoracic defect. A vascularized rib autograft was harvested and intussuscepted within a femoral allograft for reconstruction of the anterior column and supplemented with posterior and lateral instrumentation. Conclusion: This report demonstrates the feasibility of using a rib autograft within a femoral allograft sleeve to achieve immediate robust biomechanical support and eventual osseous union after thoracic TES for malignant tumors.

Keywords: vascularized rib; rib; reconstruction; spondylectomy; anterior column

Journal Title: JBJS Case Connector
Year Published: 2022

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