Iliac crest versus artificial bone grafts in 250 cervical fusions

1994 ◽  
Vol 129 (1-2) ◽  
pp. 54-57 ◽  
Author(s):  
S. Savolainen ◽  
J. P. Usenius ◽  
J. Hernesniemi
Keyword(s):  
Iliac Crest ◽  
Bone Grafts ◽  
Artificial Bone

A comparative analysis of fusion rates and donor-site morbidity for autogeneic rib and iliac crest bone grafts in posterior cervical fusions

1998 ◽  
Vol 88 (2) ◽  
pp. 255-265 ◽  
Author(s):  
Paul D. Sawin ◽  
Vincent C. Traynelis ◽  
Arnold H. Menezes
Keyword(s):  
Comparative Analysis ◽  
Iliac Crest ◽  
Donor Site ◽  
Wound Dehiscence ◽  
Bone Grafts ◽  
Fusion Rate ◽  
Donor Site Morbidity ◽  
Cervical Fusion ◽  
Content Type ◽  
Fine Print

Object. Autogeneic bone graft is often incorporated into posterior cervical stabilization constructs as a fusion substrate. Iliac crest is used frequently, although donor-site morbidity can be substantial. Rib is used rarely, despite its accessibility, expandability, unique curvature, and high bone morphogenetic protein content. The authors present a comparative analysis of autogeneic rib and iliac crest bone grafts, with emphasis on fusion rate and donor-site morbidity. Methods. A review was conducted of records and radiographs from 600 patients who underwent cervical spinal fusion procedures in which autogeneic bone grafts were used. Three hundred patients underwent rib harvest and posterior cervical fusion. The remaining 300 patients underwent iliac crest harvest (248 for an anterior cervical fusion and 52 for posterior fusion). The analysis of fusion focused on the latter subgroup; donor-site morbidity was determined by evaluating the entire group. Fusion criteria included bony trabeculae traversing the donor—recipient interface and long-term stability on flexion—extension radiographs. Graft morbidity was defined as any untoward event attributable to the graft harvest. Statistical comparisons were facilitated by using Fisher's exact test. Conclusions. Demographic data obtained in both groups were comparable. Rib constructs were placed in the following regions: occipitocervical (196 patients), atlantoaxial (35 patients), and subaxial cervical spine (69 patients). Iliac crest grafts were placed in the occipitocervical (28 patients), atlantoaxial (10 patients), and subaxial cervical (14 patients) regions. Fusion occurred in 296 (98.8%) of 300 rib graft and 49 (94.2%) of 52 iliac crest graft constructs (p = 0.056). Graft morbidity was greater with iliac crest than with rib (p < 0.00001). Donor-site morbidity for the rib graft was 3.7% and included pneumonia (eight patients), persistent atelectasis (two patients), and superficial wound dehiscence (one patient). Pneumothorax, intercostal neuralgia, and chronic chest wall pain were not encountered. Iliac crest morbidity occurred in 25.3% of the patients and consisted of chronic donor-site pain (52 patients), wound dehiscence (eight patients), pneumonia (seven patients), meralgia paresthetica (four patients), hematoma requiring evacuation (three patients), and iliac spine fracture (two patients). Even when chronic pain was not considered, morbidity encountered in obtaining iliac crest still exceeded that encountered with rib harvest (p = 0.035). The fusion rate and donor-site morbidity for rib autograft compare favorably with those for iliac crest when used in posterior cervical constructs. To the authors' knowledge, this represents the largest series to date in which the safety and efficacy of using autogeneic bone graft materials in spinal surgery are critically analyzed.

COMPARISON OF ANTERIOR AND POSTERIOR ILIAC CREST BONE GRAFTS IN TERMS OF HARVEST-SITE MORBIDITY AND FUNCTIONAL OUTCOMES

2002 ◽  
Vol 84 (5) ◽  
pp. 716-720 ◽  
Author(s):  
ELKE AHLMANN ◽  
MICHAEL PATZAKIS ◽  
NIKOLAOS ROIDIS ◽  
LANE SHEPHERD ◽  
PAUL HOLTOM
Keyword(s):  
Functional Outcomes ◽  
Iliac Crest ◽  
Bone Grafts ◽  
Posterior Iliac Crest ◽  
Harvest Site

Secondary Bone Grafting of Alveolar Clefts: A Densitometric Comparison of Iliac Crest and Tibial Bone Grafts

2001 ◽  
Vol 38 (1) ◽  
pp. 11-14 ◽  
Author(s):  
V. Sivarajasingam ◽  
G. Pell ◽  
M. Morse ◽  
J. P. Shepherd
Keyword(s):  
Bone Density ◽  
Optical Density ◽  
Bone Grafting ◽  
Iliac Crest ◽  
Objective Assessment ◽  
Bone Grafts ◽  
Orthodontic Appliances ◽  
Density Measurements ◽  
Tibial Bone ◽  
Alveolar Bone Grafting

Objective To evaluate changes in the optical density of secondary alveolar cleft bone grafts obtained from two different donor sites over time and to determine whether one donor site gives a higher recipient bone density than the other. Methods A prospective study was performed evaluating 40 healthy patients with congenital cleft lip and palate undergoing secondary alveolar bone grafting, 20 (14 boys and 6 girls) having iliac crest and 20 (12 boys and 8 girls) receiving tibial bone grafts. Bone harvest and grafting was carried out by one operator (G.P.). Optical density of iliac and tibial grafts measured using a computerized densitometer, was compared at 6 days, 6 weeks, and 3 months. Due to interference from orthodontic appliances, optical density measurements for 16 subjects were not possible, and these patients were excluded from the study. The length of hospital stay postoperatively for both grafting procedures were recorded. Results A significant decrease in relative bone density was demonstrated during the 3-month postoperative period in both iliac and tibial bone graft groups (p < .05). The difference in densities between iliac crest and tibial groups were not significantly different at any of the time points (paired t test, p > .05). Subjects undergoing iliac crest grafts stayed an average of 5 days in the hospital postoperatively, compared with subjects with tibial grafts who stayed an average of 3 days postoperatively. Conclusion Optical density measurements of bone grafted into alveolar clefts, reported here for the first time, provide a valuable objective assessment of graft progress. Tibial and iliac crest grafts gave similar optical densities at recipient sites over the first 3 months. Iliac crest grafts required significantly longer postoperative stay; an important consideration in selecting donor sites for secondary bone grafting.

Tissue reaction around miniplates used for the fixation of vascularized iliac crest bone grafts

1997 ◽  
Vol 83 (4) ◽  
pp. 433-440 ◽  
Author(s):  
Ralf Schön ◽  
Rainer Schmelzeisen ◽  
Tatsuo Shirota ◽  
Kohsuke Ohno ◽  
Ken-Ichi Michi
Keyword(s):  
Iliac Crest ◽  
Bone Grafts ◽  
Tissue Reaction

Alveolar Ridge Augmentation: A Comparative Longitudinal Study Between Calvaria and Iliac Crest Bone Grafts

2005 ◽  
Vol 31 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Francesco Carinci ◽  
Antonio Farina ◽  
Umberto Zanetti ◽  
Raffaele Vinci ◽  
Stefano Negrini ◽  
...  
Keyword(s):  
Bone Graft ◽  
Linear Model ◽  
Iliac Crest ◽  
General Linear Model ◽  
Bone Grafts ◽  
General Linear ◽  
Autogenous Bone ◽  
Maxillary Bone ◽  
Ridge Augmentation

Abstract Insertion of endosseous implants is often difficult because of lack of supporting bone. In the case of severe atrophy of the jaws, a large volume of autogenous bone can be harvested from the iliac crest and calvaria. Both grafts undergo partial resorption with time, but the rate of bone loss has not been fully elucidated. The aim of this study was to evaluate the alveolar bone height gain (ABHG) obtained with iliac crest and calvaria bone grafts. Twenty-five patients had mandibular bone grafts, 32 had maxillary bone grafts, and 11 had both mandibular and maxillary bone grafts. Measures were made on preoperative, postoperative, and follow-up radiographs. A general linear model was used to evaluate the rate of ABHG plotted against months elapsed from the time of the operation to the time of follow-up. General linear model output showed a statistically significant effect for only the type of donor bone graft (P = .004), with a better ABHG for calvaria. The iliac crest bone grafts lost most of the ABHG in the first 6 months, whereas calvaria bone grafts lost ABHG over a greater interval of time. The type of bone graft is the strongest predictor of ABHG, and calvaria bone graft had a higher stability than did iliac bone graft. However, the gap in ABHG between the 2 grafts tended to decrease over time.

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