A 35-year-old woman presented with back pain, progressive weakness in her bilateral lower extremities, and inability to walk for 2 months. Imaging demonstrated anterior destruction of T10, T11, T12, and L1 with severe retropulsion and cord impingement at T11-T12. The patient was taken for anterolateral corpectomies of T10-L1 with decompression of the thoracic spinal cord and fibular strut autograft placement followed by a T8 to L3 posterior spinal fusion. An intramedullary Kirschner-wire (K-wire) was placed during the anterolateral procedure to enhance fibular graft placement and prevent dislodgement before definitive posterior fusion.
At follow-up five-and-a-half months after the operation, the patient had recovered full strength and was ambulating without difficulty. Imaging at this time demonstrated stable restoration of alignment without graft dislodgement. Intramedullary fibular K-wire placement in this procedure helped to optimize anterior column reconstruction. The principles used in this report may prove beneficial to surgeons in developing countries who encounter pathology of this extent.