[Vertebral body replacement with a rib segment block in transthoracic intervention]

Area of Science:

• Spine Surgery
• Orthopedic Oncology
• Bone Grafting

Background:

• Destructive lesions in the thoracic spine often require vertebral body replacement.
• Autologous bone grafts are a common solution, but donor site morbidity can be a concern.

Observation:

• This clinical report evaluates a novel technique using fused autologous rib bone segments for vertebral body replacement in 7 patients.
• The rib segments were fused with titanium screws to create a bone block for thoracic spine reconstruction.

Findings:

• All patients achieved radiological bony fusion of the rib implants.
• 83.3% of patients experienced neurological improvement following ventral decompression.
• A mean initial correction of 9.4 degrees was achieved, but a secondary loss of 11.4 degrees was noted due to implant subsidence.

Implications:

• Composed rib blocks offer a viable alternative for vertebral body replacement, providing stability and osteogenic capacity.
• Minimizing secondary correction loss may require additional ventral fusion with osteosynthesis plates or dorsal fixation.
• Harvesting autologous rib grafts during the primary surgical approach reduces operative time and complications.