Autologous donor site morbidity after posterior iliac crest bone harvest. Comparative analysis of two surgical techniques

DOI: https://doi.org/10.15417/issn.1852-7434.2020.85.1.704
Keywords: graft, autologous, arthrodesis, pain

Abstract

Introduction: The autologous bone graft harvested from the posterior iliac crest for spinal fusion presents osteogenic, osteoinductive and osteoconductive advantages; however, its disadvantages include a limited amount of available material and an incidence of donor site complications ranging from 8% to 39%, including donor site pain, neurovascular injury and pelvic fractures. 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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Author Biographies

Pedro Luis Bazán, Hospital Italiano de La Plata, Buenos Aires, Argentina
Hospital Interzonal General de Agudos General José de San Martín, La Plata, Buenos Aires, Argentina
Jorge Delfor Cancinos, Ortopedia y Traumatología, Sanatorio Ipensa, La Plata, Buenos Aires, Argentina
Especialista Certificado en Cirugía de Columna Vertebral.  Especialista Certificado en Ortopedia y Traumatología de la AAOT Especialista Consultor en Ortopedia y traumatología del Colegio de Médico Distrito I
Álvaro Enrique Borri, Hospital Italiano de La Plata, Buenos Aires, Argentina
Especialista Certificado en Cirugía de Columna Vertebral.  Especialista Certificado en Ortopedia y Traumatología de la AAOT Especialista Jerarquizado en Ortopedia y traumatología del Colegio de Médico Distrito I
Nicolás Romano Yalour, Hospital Italiano de La Plata, Buenos Aires, Argentina
Especialista Jerarquizado en Ortopedia y traumatología del Colegio de Médico Distrito I

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Published
2020-01-30
How to Cite
Bazán, P. L., Cancinos, J. D., Borri, Álvaro E., & Romano Yalour, N. (2020). Autologous donor site morbidity after posterior iliac crest bone harvest. Comparative analysis of two surgical techniques. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 85(1), 31-38. https://doi.org/10.15417/issn.1852-7434.2020.85.1.704
Issue
Vol 85 No 1 (2020)
Section
Clinical Research

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