Abstract : Synthetic vertebral body replacement has been widely used recently to treat different spinal conditions affecting the anterior column. They arrange from trauma, infections and even tumor conditions. In this study, we assess the functional outcome of this modality in different spinal conditions. Thirty-six cases operated from Oct. 2010 to Dec. 2017. Twelve patients had spinal type A3 fractures, 11 cases with spinal tuberculosis, and 13 cases with spinal tumors. They were followed clinically for a mean period of 2.4 years. All the cases were approached anteriorly. Seven cases had a postoperative infection. No neurological worsening reported. We had dramatic neurological improvement in all spinal tuberculosis cases. Mortality recorded in only four cases with metastatic spinal tumors during the mean period of follow up. Karnofsky performance status scale showed statistically significant change for spinal tuberculosis, and tumor cases during the follow-up period, but there was no significant change in cases of spinal type A3 fractures. The positive outcome of this surgery makes it recommended for properly picked patients especially with spinal tuberculosis and tumors