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.
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