Harvesting Rib Graft

One of the best autogenous bone graft harvesting method is taking the tenth rib all the way back to its vertebral body. It is best to harvest the tenth rib from the outside back to the spinal extensor muscles and then from the inside from the spinal extensor muscles to the articulation with the vertebral body. This makes closure easier and preserves the spinal extensor muscles. It can be thought that it is hard to reach to the T10 vertebral body through a tenth rib thoracotomy, and that taking the eighth or ninth rib is easier. However, taking the eighth or ninth rib usually causes more disruption of the serratus anterior muscle. Getting to the superior order of the tenth vertebral body is difficult if one only harvests the tenth rib back to the spinal extensor muscles. But if the tenth rib is disarticulated from the vertebral body, then access to the superior portion of T10 is quite straightforward.

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