Autologous donor site morbidity after posterior iliac crest bone harvest. Comparative analysis of two surgical techniques
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Abstract
Objectives: To compare the posterior iliac crest corticoancellous harvest using a chisel-gouge approach versus a curette approach; to evaluate intra-operative and post-operative complications; to quantify the harvested bone; to grade donor site pain.
Materials and Methods: Prospective randomized study in 34 consecutive patients for posterolateral fusion of the thoracic and lumbosacral spine; 26 women and 8 men, between 15 and 79 years of age. Subjects were divided into two groups. Group 1: curette approach; and Group 2: chisel-gouge approach. The evaluation included: the amount of bone harvested, the time required and complications.
Results: Group 1: 19 patients, 14 women and 5 men. The procedure lasted an average of 9.94min, and the harvested material averaged 9.26g. Denis Pain Scale scores at the first follow-up survey: 13 patients scored 1; 5 scored 2; 1 scored 3. Denis Pain Scale scores at the third follow-up survey: 15 patients scored 1; 2 scored 2; 1 scored 3. Group 2: 15 patients, 12 women and 3 men. The procedure lasted an average of 8.6min, and the harvested material averaged 9.26g. Denis Pain Scale scores at their first follow-up: 10 patients scored 1; 2 scored 2; 3 scored 3. At the third follow-up, all patients scored 1.
Conclusions: We observed that the posterior iliac crest graft harvested using the chisel-gouge approach is faster, provides more graft and results in less pain at 60 days.
Level of Evidence: II
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