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Review
. 2021 Feb;35(1):37-40.
doi: 10.1055/s-0041-1725986. Epub 2021 May 10.

Vascularized Posterior Iliac Crest Bone Grafting: Indications, Techniques, Clinical Outcomes, and Alternatives

Sebastian J Winocour  1 , Kelly P Schultz  1 , Matthew J Davis  1   2 , Amjed Abu-Ghname  1   2 , Michael Bohl  3 , Alexander E Ropper  4 , Marco Maricevich  1 , Edward M Reece  1   2   4
Affiliations
Review

Vascularized Posterior Iliac Crest Bone Grafting: Indications, Techniques, Clinical Outcomes, and Alternatives

Sebastian J Winocour et al. Semin Plast Surg. 2021 Feb.

Abstract

Pseudarthrosis is a feared complication of spinal fusion procedures. Currently, the gold standard in prevention or treatment of pseudarthrosis is placement of nonvascularized iliac crest bone autograft. While rates of fusion are significantly higher in patients with use of nonvascularized bone autografts than with allografts, patients who have previously failed lumbar arthrodesis or those at a high risk for pseudarthrosis may benefit from a more robust, vascularized bone graft with enhanced osteogenicity. In this article, we discuss the use of iliac crest vascularized bone grafts as an adjunct for high-risk patients undergoing lumbosacral spine arthrodesis.

Keywords: autograft; iliac crest; pseudoarthrosis; spinal fusion; spinoplastic reconstruction; vascularized bone graft.

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Conflict of interest statement

Conflict of Interest Dr. Ropper receives consulting fees from Globus Medical and Stryker, but they have no conflict with this report.

Figures

Fig. 1
Fig. 1
Illustration of a pedicled iliac crest vascularized bone graft after elevation and inset. A segment of the iliac crest has been elevated on a quadrates lumborum muscle pedicle, tunneled under the paraspinous muscles, and rotated into a defect in the lumbar spine.
See this image and copyright information in PMC

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