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Review
. 2021 Feb;35(1):31-36.
doi: 10.1055/s-0041-1725985. Epub 2021 May 10.

Vascularized Rib Bone Grafting: Indications, Techniques, and Clinical Outcomes

Sebastian J Winocour  1 , Nikhil Agrawal  1 , Kathryn M Wagner  2 , Matthew J Davis  1   3 , Amjed Abu-Ghname  1   3 , Rohil Shekher  1 , Michael R Raber  2 , Michael A Bohl  4 , Alexander E Ropper  2 , Edward M Reece  1   2   3
Affiliations
Review

Vascularized Rib Bone Grafting: Indications, Techniques, and Clinical Outcomes

Sebastian J Winocour et al. Semin Plast Surg. 2021 Feb.

Abstract

Pseudarthrosis is a difficult complication often seen in patients with complex spinal pathology. To supplement existing neurosurgical approaches to cervicothoracic spinal instrumentation and fusion, novel vascularized rib bone grafts can be utilized in patients at high risk for failed spinal fusion. In this article, we discuss the indications, benefits, surgical technique, feasibility, and limitations of using rib vascularized rib bone grafts to augment spinal fusion.

Keywords: autograft; pseudoarthrosis; spinal fusion; spinoplastic reconstruction; vascularized bone graft; vascularized rib graft.

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Conflict of interest statement

Conflict of Interest Dr. Ropper receives consulting fees from Globus Medical and Stryker, but they have no conflict with this report.

Figures

Fig. 1
Fig. 1
Decision tree for the selection of which bone graft to use.
Fig. 2
Fig. 2
Utilization of the left 8th rib for placement in posterior L2–L3 gutter for augmentation of instrumented spinal fusion.
Fig. 3
Fig. 3
Markings for the donor site incision.
Fig. 4
Fig. 4
Exposure of the rib for harvest.
Fig. 5
Fig. 5
Here the rib is seen being elevated out of the donor site.
Fig. 6
Fig. 6
The rib in place along the posterior spinal column. The rib is outlined in clue. The pedicle is marked with the yellow arrow.
See this image and copyright information in PMC

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