Iliac Crest Bone Graft Harvesting: Modified Technique for Reduction of Complications

Abstract

Bone graft harvesting is one of the common procedures in orthopaedics surgery, and iliac crest is the gold standard donor site for autologous bone graft. There are a number of complications related with harvesting iliac crest bone graft, "donor site pain" is the commonest one. We modified the conventional surgical technique for autogenous iliac crest bone graft on patients who underwent anterior cervical decompression/corpectomy and fusion surgeries. Among 23 patients, 18 didn't complain more pain at the donor site compared to the neck pain on the first postoperative day and the wound on the iliac crest did not affect their mobilisation. Mean Visual Analog Score was 2.62±1.80, 1.83±1.41, and 1.10±1.20 at the time of suture removal (14 days), at six weeks and three months respectively. At one year of follow-up, no patient complained of donor site pain. Our surgical modification has encouraging results and thus can be advocated for bone graft.

Keywords: bone grafting; complications; iliac crest; pain.

Figure 1. The intraoperative photograph shows the technique of stretching the skin towards the abdomen.

Figure 2. A) The incision is made on the outer margin of the iliac crest over the fascial attachment of muscles and periosteum, B) The iliac crest after elevating the periosteum together with a wafer of bone.

Figure 3. A) The periosteum with wafers of bone and muscles are opposed and sutured, B) After the suturing the incised skin. The external contour of the iliac crest is maintained and the skin suture is low lying.