2020 Volume 11 Issue 4 Pages 754-757
For the treatment of the tuberculous spondylitis, adequate curettage of the involved lesion and restoring spinal stability are mandated. It, however, may be difficult to take bone graft that correspond to replace large defect after curettage. We performed vascularized rib graft for anterior fusion of the thoracolumbar spine. The case was an 80-year-old female with spinal tuberculosis at the L1-2 level. She was presented to our hospital with low back pain. Magnetic resonance imaging (MRI) demonstrated a huge mass compressing spinal cord at the L1-2 vertebral level. We performed posterior spinal fixation using percutaneous pedicle screws, followed by anterior spinal fusion with vascularized rib graft one month after the initial surgery. A 16 cm vascularized graft was carried from the 10th rib. The graft was folded into two pieces to a length adequate to fill the defect and inserted as a pedicled vascularized graft from Th12 to L3. After 3 months, she was able to regain movement with relieved pain. No recurrence of the tuberculous spondylitis was noted in the follow-up period. We conclude that vascularized rib graft is a useful treatment for cases with destruction involving multiple vertebral bodies.
