Bridge Reconstruction of Donor Iliac Crest with Resected Rib in Anterior Fusion of Thoracolumbar Spine

Kim, Yong Min; Won, Choong Hee; Choi, Eui Seong; Seo, Joong Bae; Lee, Ho Seung; Lee, Kyoung Bae

Abstract

STUDY DESIGN: A retrospective study about the efficacy of bridge reconstruction of donor iliac defect utilizing resected rib dur-ing surgical approach of thracolumbar vertebrae.
OBJECTIVES
To evaluate the outcome in clinical aspect for cosmesis and pain, and radiological aspect for incorporation of rib with crest. SUMMARY OF LITERATURE REVIEW: Many iliac donor site problems were reported such as pain, deformity, fracture etc. Filling the bone defect with bone, cement, or artificial bone seems to reduce the donor site problems.
MATERIALS AND METHODS
In fourteen patients who underwent anterior fusion of vertebrae, bridge reconstructions of iliac crest using resected rib for thoracoabdominal approach to vertebral body were performed. Postoperatively, donor site pain, residual deformity, and radiologic finding of the union between rib and iliac crest were evaluated.
RESULTS
No patients had significant pain on donor iliac crest. Acceptable pain was complained by five patients after 1 month postoperatively and by three patients after 2 months postoperatively. After 3 months, no patients had pain problem at iliac donor site. Two patients presented palpable step-off on iliac crest, but external contours of iliac crest were satisfactory in all patients. Radi-ologic union of the rib-crest junction was confirmed within 6 months postoperatively in all cases.
CONCLUSIONS
Bridge reconstruction of iliac crest defect using resected rib is a simple and effective method that can minimize residual donor site problems in anterior spinal surgeries of thoracic and upper lumbar vertebrae.