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The Use of Autografts for Vertebral Body Replacement of the Thoracic and Lumbar Spine

COTLER, HOWARD B., MD; COTLER, JEROME M., MD; STOLOFF, AMY, BA; COHN, HERBERT E., MD; JERRELL, BRUCE E., MD; MARTINEZ, LUCAS, MD; NORTHRUP, BRUCE E., MD; OSTERHOLM, JEWELL L., MD; ROSATO, FRANCIS E., MD

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Thirty-seven patients with fractures of the thoracic or lumbar spine underwent anterior corpectomy (partial or complete) and vertebral body replacement for either destructive lesions from tumor or infection (13 patients) or trauma (24 patients). The vertebral bodies were replaced using either rib (12 patients) or tricortical iliac crest (25 patients) autografts. The Dunn device was utilized in conjunction with the autografts in 19 patients. Posterior stabilization was used in five patients; three prior to anterior stabilization and two after anterior stabilization. Within 2 weeks of the operative procedure, all patients began walking or sitting. Of the 37 patients, 21 with incomplete neurologic deficits improved, and 10 of those went onto complete recovery. Of the 27 patients who have been followed for a minimum of 1 year, 25 have obtained solid fusions, one developed a pseudarthrosis that required regrafting, and one had a delayed union prior to death from metastatic disease. There were two deaths in the immediate postoperative period and three deaths in the first six postoperative wounds due to metastatic disease. The purpose of this study is to present a consecutive series of patients who have undergone corpectomy and vertebral body replacement as well as to define the adequacy of stabilization.

From Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania

© Lippincott-Raven Publishers.