J Korean Soc Spine Surg.  2006 Jun;13(2):87-92. 10.4184/jkss.2006.13.2.87.

Reconstruction of Iliac Crest Donor Site Using 1/3 Tubular Plate

• Shin DE
• Cho DY
• Han SH
• Kim JH
• Lee SC

• KMID: 2097823
• DOI: http://doi.org/10.4184/jkss.2006.13.2.87

Abstract

STUDY DESIGN: This is a prospective study
OBJECTIVES
The purpose of this study is to describe the technique for reconstruction of the iliac crest graft donor site and to determine the clinical results of its application. Summary of literature REVIEW: An iliac crest tricortical bone graft is frequently used for anterior interbody fusion of the spine. For preventing iliac crest graft donor site morbidity (pain, skin dimpling, etc), various graft materials have been used, for example, rib, cement, ceramic and so on. However, the rib needs another incision for lumbar or cervical fusion, the cement sometimes causes the wound infection, and the bioactive ceramic spacer has not had its long term results confirmed.
MATERIALS AND METHODS
We prospectively analyzed 28 patients who underwent iliac crest reconstruction with a 1/3 tubular plate after bone harvesting between 1998 and 2004. Pain at postoperative 1 month, 6 months and 1 year was checked by the visual analogue scale (VAS). The cosmetic appearance, foreign body sense, overall satisfaction (according to the methods of Ito et al), complications and the radiologic evaluations were all analyzed as indicators of the outcome.
RESULTS
The mean visual analogue scale was 3.5 and 0.1 at postoperative 1 and 12 months, respectively. For the cosmetic appearance, among the 28 patients, 24 patients felt a smooth and satisfactory outline (Excellent). 25 patients couldn't feel any foreign body sense. One patient experienced wound infection. No plate breakage or screw loosening were observed.
CONCLUSIONS
Reconstruction of the iliac crest with a one-third tubular plate after tricortical bone graft harvest could be a favorable method. the screws during the consolidation of PMMA.

Keyword

Tricortical iliac bone graft; iliac crest reconstruction; 1/3 tubular plate

MeSH Terms

Ceramics
Foreign Bodies
Humans
Polymethyl Methacrylate
Prospective Studies
Ribs
Skin
Spine
Tissue Donors*
Transplants
Wound Infection
Ceramics
Polymethyl Methacrylate

Figure

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  Fig. 1. L-spine MRI, 38-year old male patient. (A) In the axial view, infectious spondylitis and discitis with paravertebral abcess is shown. (B) In the sagittal view, the prevertebral abcess and infectious spondylitis at L2 and L3 is seen

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  Fig. 2. Postoperative X-ray shows the pedicle screw instrumentation and the anterior interbody fusion with auto iliac bone graft from L1 to L4. (A) Anterior posterior view (B) Lateral view

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  Fig. 3. The iliac crest donor site is reconstructed by the 1/3 tubular plate.

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