A, Typical nonunion with fibrocartilage compromising canal. B, Collapse of graft leads to sharp angular kyphosis, which, combined with nonunion, causes compression of cord. C, Decompression through anterior approach. Hemicorporectomy performed cephalad and caudad to disc space with high-speed burr to create parallel surfaces of cancellous bone. Decompression completed with angled curets. D, Anterior bone grafting performed with tricortical Smith-Robinson bone graft countersunk into position.