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Updated: Jun 20, 2026

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
Anterior Column Reconstruction with Vascularized Rib After Thoracic Spondylectomy: A Case Report
Daniel G Tobert1, Caleb M Yeung1, Christopher R Morse2
1Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
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.

