Polysegmental stage-by-stage reconstruction of the spine using a vascularized rib graft by posterior instrumental fixation (experimental study). Part 1

The polysegmental anterior reconstruction of thoracic spine and spinal canal using free vascularized grafts from fibula in cases of spine gross deformities is not judicious. The anterior pedicle-provided rib strut-graft is used rarely, because it is not strong and it is bent; the method of plasty has no experimental-and-theoretical substantiation. The experimental-and-theoretical substantiation of the complex method of stage-by-stage reconstruction of the spine and spinal canal was made in 45 adult mongrel dogs. The method of spinal cord transposition and that of spine polysegmental ventral defect plasty using a pedicle-provided rib strut-graft by posterior instrumental fixation were developed. The effectiveness of supporting structure reconstruction during the anterior block forming in a year after plasty was 92,8%. The outcome of reconstruction depended on preservation of the rib graft blood supply and on survival of its osteogenic cells. This made available both rapid consolidation and rib organotypical transformation to a strong regenerate bone as a column. The reconstruction of spinal canal led to myelopathy in 11,2% of cases because of anterior myelocele formation.