Free Vascularized Fibula Graft with Femoral Allograft Sleeve for Lumbar Spine Defects After Spondylectomy of Malignant Tumors: A Case Report

JBJS Case Connect. 2020 Jul-Sep;10(3):e2000075. doi: 10.2106/JBJS.CC.20.00075.


Case: We present a 65-year-old man with an L4 conventional chordoma. Total en bloc spondylectomy (TES) of the involved vertebral bodies and surrounding soft tissues with reconstruction of the spine using a free vascularized fibula autograft (FVFG) is a proven technique, limiting complications and recurrence. However, graft fracture has occurred only in the lumbar spine in our institutional cases. We used a technique in our patient to ensure extra stability and support, with the addition of a femoral allograft sleeve encasing the FVFG.

Conclusions: Our technique for the reconstruction of the lumbar spine after TES of primary malignant spinal disease using a femoral allograft sleeve encasing the FVFG is viable to consider.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Allografts
  • Bone Transplantation / methods*
  • Chordoma / diagnostic imaging
  • Chordoma / surgery*
  • Free Tissue Flaps*
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery*
  • Magnetic Resonance Imaging
  • Male
  • Spinal Neoplasms / diagnostic imaging
  • Spinal Neoplasms / surgery*