Anterior Column Reconstruction Through a Posterior Corridor in the Lower Thoracic Spine and Thoracolumbar Junction: Early Radiographic Outcomes Using a Conformable Mesh Interbody Implant

Background/Objectives: Restoration of anterior column support in the lower thoracic spine and thoracolumbar junction can be challenging in the setting of segmental kyphosis, particularly when endplate integrity is compromised. A conformable mesh interbody implant can be introduced in a collapsed configuration through a transforaminal corridor and expanded in situ to accommodate the geometry of the prepared intervertebral space. This study evaluated early radiographic outcomes following anterior column reconstruction with a conformable mesh interbody implant. Methods: This retrospective single-centre study was conducted with 12 patients who underwent thoracic or thoracolumbar anterior column reconstruction using a conformable mesh interbody implant between April 2024 and March 2026. The heterogeneous cohort included degenerative disease, trauma, infection, hardware failure and pseudarthrosis. Segmental Cobb, anterior disc height and posterior disc height were measured preoperatively, immediately postoperatively and at 3-month follow-up. Paired radiographic changes were analyzed using the Wilcoxon signed-rank test. Results: Median segmental Cobb angle improved significantly from −16.2° preoperatively to −7.9° immediately postoperatively (median change +6.4°, p = 0.003), with correction maintained at 3 months (+5.5° versus baseline, p = 0.008). Anterior disc height increased from 6.0 to 9.2 mm immediately postoperatively (p = 0.004) and remained significantly greater than the baseline at 3 months despite a small early reduction in anterior disc height (+2.3 mm, p = 0.013). Posterior disc height increased from 4.3 to 7.6 mm (p = 0.021) and remained improved at 3 months (+2.1 mm, p = 0.014). Conclusions: Anterior column reconstruction through a posterior surgical corridor using a conformable mesh interbody implant appeared feasible in the lower thoracic spine and thoracolumbar junction. Significant restoration of segmental alignment and disc height was achieved, with most radiographic correction maintained at 3 months. These preliminary findings support the short-term maintenance of radiographic correction achieved with this reconstructive strategy.